Medical History – Resonance Volleyball Academy

I am over 18 years old. I am under 18 years old, and a parent/guardian, in addition to filling out and agreeing to the ‘Medical history form,’ ‘Physical activity history form,’ and ‘Code of conduct and terms form,’ is willing to send us the additional ‘Underaged Consent Form’ signed.

Underaged Consent Form

Since the member is under 18, a parent or guardian must complete, sign, and upload the Underaged Consent Form below.

Download Underaged Consent Form (PDF)

Upload signed Underaged Consent Form * Accepted: PDF, JPG, PNG — max 5 MB.

14 — Are you currently under any medical treatment? If yes, please specify the condition and medication. *

15 — Do you have any allergies? If yes, please specify the allergens. *

16 — Have you had any surgeries? If yes, please provide details. *

17 — Do you have a history of heart problems? If yes, please specify. *

18 — Do you have a history of high blood pressure? *

Yes No

20 — Do you have asthma or any breathing difficulties? *

Yes No

22 — Have you ever experienced seizures or epilepsy? *

Yes No

23 — Do you have any musculoskeletal injuries or conditions? If yes, please specify. *

26 — Are you taking any medications regularly? If yes, please list the medications. *

27 — Do you have any Psychological/Psychiatric conditions? If yes, please specify. *

28 — Have you ever been advised by a healthcare professional to avoid certain activities? If yes, please specify. *

29 — Do you have any dietary restrictions or considerations? If yes, please specify. *

It is the sole responsibility of the member or their legal guardian to notify Resonance Volleyball Academy of any changes to the information provided in this form. Failure to update information may affect the quality of care and services provided.