Submit your
PAR Q

A PAR Q is a form that screens for evidence of risk factors during moderate physical activity, ie CIRCUS! It's basic information we have to ensure that we have the details we need to keep you safe during your classes!

You only need to fill this out once, unless your details change. When that happens just inform us of the changes and we can update it on your behalf!

If you have any problems or access requirements in completing this form, please call Nat on ‭07849 038538‬

PARTICIPANT PAR Q

Before attending a class you must fill out this form.

Once filled out, we will keep it for one year but please keep us informed of changes to your personal details within this time.

If you are filling in this form for a participant under the age of 18 please enter your own contact details below.

Participant full name

Participant preferred name

DOB of participant

Participant Pronoun

Second Participant (Please use if there are multiple attendees within your profile.)

Participant full name

Participant preferred name

DOB of participant

Participant Pronoun

Third Participant (Please use if there are multiple attendees within your profile.)

Participant full name

Participant preferred name

DOB of participant

Participant Pronoun

We require a named contact in case of emergencies in case you/the participant are injured in a session.

Your emergency contact should be aware of this and should give permission for you to share their details with us.

Emergency contact name

Emergency Contact

Health information

Please tell us any information relating to your health that may affect you/ the participant's ability to take part in activities, or anything you would like us to know about your medical requirements. (This may include outstanding health conditions, regular medications, allergies etc.) If there is nothing you need to tell us please leave this section blank.

Current health conditions

Please tell us of any additional information that may help our
mentors best accommodate your/ the participants needs whilst in sessions.
If there is nothing you need to tell us, please leave this section
blank.

Support information

I aggree to inform NCA of any changes to my health that may affect my / the participants ability to safely take part in activities.

I understand that this activity has risks, I may incur a personal injury to both myself or those that I train with. I acknowledge that the teacher will take all reasonable steps to ensure safety. I understand that they cannot be liable for my own actions, for which I must take responsibility, or for those of a third party.

PHOTOGRAPHIC CONSENT
Please tick all that apply.

I give permission for photos/videos featuring me/my child taken by NCA to be used in the following ways (tick any that apply):

For internal reporting (to facillitators, funders, partners

For marketing purposes (including print and our website)

For social media (such as Facebook and Instagram)

For print (posters, flyers)

I agree on submitting all of the information provided is true.

Thanks for submitting!

NEWCASTLE CIRCUS ARTS

Submit your PAR Q

PARTICIPANT PAR Q

Submit your
PAR Q