October 19 | PARE Test Registration Please enable JavaScript in your browser to complete this form. – Step 1 of 4 PARE Registration – October 19 Course Date: Saturday, October 19, 2024 Time: 11:30 am – 1:30 pm Location: Mohawk College, (135 Fennell Ave W. Hamilton, ON), Room C143. For a map of campus and directions, click here. Cost: $85.00 + HST ($96.05) Please complete these forms and bring them with you to the PARE Test/Practice. Get Active Questionnaire (PDF) Informed Consent for PARE (PDF) Contact InformationName *FirstLastEmail *EmailConfirm EmailPhone *NextPersonal Health InformationPlease answer the following questions as accurately as possible. Gender *Please select one of the followingMaleFemaleOtherAge *Do you need a MEDICAL NOTE from your doctor? Are you OVER 40 year of age? If so, then YES you need a MEIDCAL NOTE regardless of your fitness level. Please download the form and bring it with you. PARE Medical Clearance Height (ft. or cm) *Weight (lbs. or kg) *Average Number of minutes per week of physical activity (moderate to intense) in the past 3 months. *mins/weekIn preparation for the applicant PARE have you increased your level of physical activity in the past month *YesNoWhat Agency are you testing for? *CBSARCMPOtherOther *Please explainPreviousNextEmergency ContactPlease provide the name and contact information of someone we can call incase of an emergency.Name *FirstLastRelationship *Phone *PreviousNextPlease select your payment option. *Online credit card – $96.05Etransfer – $96.05Payment *Etransfer Payment Information NOTE: Registration is not confirmed until payment is made. Please e-transfer payment to emergencyservicestraining.info@gmail.com. Include your full name and testing date in the comments. Please complete these forms and bring them with you to the PARE Test/Practice. Get Active Questionnaire (PDF) Informed Consent for PARE (PDF) PreviousSubmit Please contact emergencyservicestraining.info@gmail.com if you have any questions.
