Youth PAR-Q for Under-18s | Ups N Downs Coaching

The Youth PAR-Q

Four Steps, About 10 Minutes

Their details first, then their health, medication and support, then your declaration. Answer honestly: it’s how I keep every session safe.

"*" indicates required fields

1Their Details

2Health Check

3Medication and Support

4Declaration

Comments

This field is for validation purposes and should be left unchanged.

This questionnaire helps me spot any health, medical or injury needs that could affect a young person's running, fitness or training sessions with me. Please answer every question honestly.

A parent or legal guardian must fill in or approve this form for anyone under 18. It doesn't replace professional medical advice.

The Young Person

Young Person's Full Name*

First Last

Date of Birth*

YYYY

Age*

Parent or Guardian

That's you, if you're filling this in.

Parent/Guardian Full Name*

First Last

Relationship to the Young Person*

Parent/Guardian Mobile Number*

Parent/Guardian Email Address*

Your copy of the form comes here, so it's worth typing twice.

Enter Email Confirm Email

Emergency Contact

Who should I call in an emergency? This can be you.

Emergency Contact Name*

Relationship to the Young Person*

Emergency Contact Phone Number*

Please answer Yes or No to each question. If you answer Yes to any of them, you'll be able to tell me more.

1. Does the young person have any diagnosed medical condition that may affect their ability to exercise safely?*

Yes

2. Do they have asthma or another breathing or respiratory condition?*

Yes

3. Have they ever experienced chest pain or unusual tightness in their chest during physical activity?*

Yes

4. Have they ever experienced dizziness, fainting, loss of consciousness or unexplained loss of balance?*

Yes

5. Do they have any bone, joint or muscular condition or injury that could be affected by physical activity?*

Yes

6. Have they recently had an injury, operation or medical procedure that could affect their ability to exercise?*

Yes

7. Do they take any medication I should be aware of?*

Yes

8. Do they have any allergies I should be aware of?*

Yes

9. Is there anything else regarding their health or wellbeing that may affect their ability to participate safely?*

Yes

Thank you for telling me. I'll read your answers before their first session and may ask to talk them through with you. If you're not sure whether they're well enough to exercise, please check with their GP first.

Tell me more about your Yes answers*

Which question does each answer relate to? Include anything that will help me support them safely.

Medication

Do they need to carry prescribed medication during sessions, such as an inhaler?*

Yes

Not applicable

Tell me about their medication*

What it's called, what it's for and when they might need it.

Is there anything I need to know about getting to or using this medication in an emergency?

Additional Support

Are there any additional needs, disabilities or reasonable adjustments you'd like me to be aware of?*

Yes

Prefer to discuss this privately

Please tell me anything that would help me support them

That's absolutely fine. I'll get in touch to arrange a private chat before their first session.

Their Health Information*

I'll only use these answers to coach them safely. My privacy policy explains how I look after them, how long I keep them and how to ask me to delete them.

I agree to Ups N Downs Coaching keeping these health answers so their training can be planned safely.

Please read the declaration and tick to confirm. Then type your full name, which counts as your signature.

Parent/Guardian Declaration*

I confirm that the information provided on this form is accurate to the best of my knowledge.
I will inform Ups N Downs Coaching if there is a significant change to the young person's health, medication or injury status.
I understand that this questionnaire is a health screening tool and does not replace professional medical advice.
If I have concerns about whether the young person is medically able to exercise, I will seek appropriate advice from a healthcare professional before they participate.
I give permission for the young person named on this form to participate in appropriate running, fitness and coaching activities.

I confirm all five statements above.

Parental Responsibility*

I confirm that I am the young person's parent or legal guardian, or have authority to provide this consent.

Your Full Name*

Typing your name here is your signature on this form.

Date of Declaration*

Today's date is filled in for you.

Good to Know

Before You Start

Fill this in as their parent or legal guardian.
Have their emergency contact’s name and number to hand.
Tell me about any medication they carry, such as an inhaler.
Need a break? Save and Continue Later sends you a link that works for 30 days.
When you send it, a copy of your answers comes to your inbox.

About Me
Welcome Pack (18 and Over)

Stuck on a question? Message me on WhatsApp.

Before They TrainFor Under-18s