Fitness Questionnaire | Epic One Adventures

Full Name

First Last

Email Address*

Phone #*

Age*

Do you have any physical conditions we should be aware of?*

Please Describe

Do you have any allergies?*

Please Describe

Do you have any food restrictions?*

Please Describe

Do you have any joint pain?*

Please Describe

Do you take blood pressure medication?*

Do you ever lose your balance due to dizziness?*

Are you afraid of heights?*

Do you get motion sickness?*

Do you exercise?*

How Often?

Do you know of any other reason why your physical activity should be limited?*

Please Describe

FITNESS RATING

For the benefit of our clients, Epic One uses a 1-5 rating system per day to help our clients determine their own physical abilities. 1 is the least strenuous, and 5 is the most strenuous.

Please select the number you feel best describes your maximum level.*

(1) This would be considered very easy, with very little cardio required. Elevation gain of 300’ or less per mile. Distances of 3 miles or less.
(2) One step above a level 1, cardio might be engaged slightly more. Elevation gain of between 300’-500’ per mile. Distances between 3-6 miles.
(3) This would be considered the middle of the road for any fit person. Cardio is engaged at a steady pace and a 5-10 minute break per hour would be warranted. Elevation gain of 500’-750’ per mile. Distances between 6-10 miles.
(4) You will be pushing yourself at times to 75% of your ability. Strenuous cardio at times. Good endurance is a must. Frequent rest stops are needed. Elevation gain up to 1000’ per mile. Distances up to 10 miles.
(5) You will be pushing yourself to your absolute limit. Extreme cardio and heart rate at times. Frequent stops to rest and replenish. Elevation gain between 1000’-2000’ per mile. Distances of 10 miles or more.

FITNESS RATING

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