Please list any allergies, including food allergies (not preferences), bug bites, medications etc. Put none if no allergies.
Please list any medications you are taking, including prescription, non-prescription and nutritional supplements.
Please describe your overall health as well as you can.
Do you see a Doctor regularly for any chronic conditions? If yes, please explain.
Please list any past surgeries, significant injuries and hospitalizations.
Please describe below.
Cardiac DiseaseDiabetesStrokeSeizuresHigh Blood PressureGastro-Intestinal DiseaseLung DiseaseKidney ProblemsLiver ProblemsCancerThyroid ProblemsMigrainesMusculoskeletal ProblemsAbnormal Bleeding, Blood ProblemsMental Health Disorders
This section requires you to read our Technical Skills & Fitness Levels Section to determine your level of physical fitness and technical skill level. Please refer to our rating system before entering the below questionnaire. It is very important for us to have an understanding of your level of riding skills and your fitness levels.
---1 (Not active)2 (I am working on getting into shape)3 (I am relatively in good shape)4 (I am in great shape)5 (I am a super fit machine)
---1 (Newbie)2 (Beginner)3 (Intermediate)4 (Strong Intermediate)5 (Advanced)
---Help!Doggy PaddlerStrong swimmer
Would you or you Doctor say you have any significant physical limitations?
Feel free to tell us anything else you feel might help.
Please describe any dietary restrictions. We will do our best to suit your needs. Feel free to include your favourite kind of foods.
I have Read The Skills & Fitness Rating For This Ride