First name
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Last name
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Date of birth
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Gender
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Address
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Email
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Repeat email
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Mobile number
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Emergency Contact Name
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Emergency Contact Number
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Ethnicity
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PAR-Q Questions
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Has your doctor ever said you have a heart condition or high blood pressure?
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Do you have a long term disability? (If yes, please specify)
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Do you have a bone, joint or spinal problem? (e.g. arthritis, osteoporosis, hip replacement)
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Do you have any respiratory problems at rest or with mild exercise? (e.g. shortness of breath, asthma)
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Do you have a mental health condition? (e.g. depression, anxiety)
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Do you have any other medical conditions?
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If yes, please state below...
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Is there any other reason you should not take part in physical activity?
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If yes:
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In the past 7 days, on how many days did you do a sport, fitness activity (such as gym or fitness classes), or dance?
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How much time did you usually spend doing sport, fitness activities, or dance on each day that you did the activity? (Hours and minutes per day)
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Was the effort you put into doing sport, fitness activities, or dance enough to raise your breathing rate?
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Not including time spent sleeping, how much time do you spend in a sedentary position on a daily basis? (include time spent sitting, watching TV, in front of computer etc)
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Wellbeing Questions
For the following questions on a scale of 0 to 10, 0="not at all" and 10= "completely"
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Overall, how satisfied are you with your life nowadays?
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Coronavirus Disclaimer
It is of the upmost importance that we at Wycombe Wanderers Sports & Education Trust safeguard the health and wellbeing of all staff, participants and immediate families at/during our activities. Therefore, please answer the following honestly and truthfully to ensure the safety of all involved in our activities.
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Have you, or anyone in your immediate family, had or shown any symptoms of Covid-19 in the last 14 days? (Dry Cough, Tiredness or Fever?
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Mailing list Disclaimer
We at Wycombe Wanderers Sports & Education Trust would like to keep you up-to-date with the latest information, news and offers relevant to our WWSET activities. This will only ever be done via email.
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Are you happy for WWSET to add your email to our mailing list?
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Photography Disclaimer
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May Wycombe Wanderers Sports & Education Trust use image(s) of the participant in printed publicity or promotional literature, to be produced by WWSET, including website stories, social media content, leaflets, posters, newsletters and other display material?
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Data Protection Disclaimer
The information you supply will be used by the Wycombe Wanderers Sports & Education Trust for administrative purposes within the terms of the Data Protection Act 1998. We shall not supply it to any third parties. Click here to go to be directed to the WWSET Privacy Policy.
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Price Category
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WWSET Charitable Donation
Financial donations help WWSET achieve positive change within our local community. If you would like to make an additional financial contribution to assist us in the work we do it would be hugely appreciated.
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Would you like to make an additional donation to WWSET..?
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