Terms and Conditions

Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice. This is especially important if:

• Your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor.
• You feel pain in your chest when you are physically active.
• In the past month, you had chest pain when you were not doing physical activity.
• You lose your balance because of dizziness or you ever lose consciousness.
• You have a bone or joint problem that could be made worse by a change in your physical activity.
• Your doctor currently prescribes drugs (for example, water pill) for your blood pressure or heart condition.
• You are or may be pregnant.
• You know of any other reason why you should not be physically active. Begin your physical activity slowly and build up gradually. If you are not feeling well because of a temporary illness, such as a cold or a fever, wait until you feel better and talk with your doctor.

Legal Disclaimer

By checking this box I understand the information above and have asked my doctor if I have any questions about participating in Move and Improve and Move and Improve activities. I release EMHS and Affiliates, their employees and agents from any liability if I injure myself or become ill as a result of participating in Move and Improve. I am at least 18 years old, or have parental permission to participate in Move and Improve activities.

Adapted from the 1994 revised version of the Physical Activity Readiness Questionnaire (PAR-Q and You).