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Pre Clinic Questionnaire.

    Tell us about yourself. All information provided here will be treated in the strictest confidence.

    Your weight in pounds.
    In the past two months, how often do you get at least 20 minutes of exercise?
    Have you ever flown kite before?
    IE Cycling, horseback riding, sailing, skydiving, pro level hot dog eating, Etc...

    Medical Information. 

    If "Yes" please describe in the field below.
    If "Yes" please describe the condition(s) in the field below.
    Do you have any Orthopedic Surgical history? If so Please explain.
    If "Yes" please describe.
    These include both Prescribed and Over the counter. If "Yes" please describe in field below.
    Is there any medical history that you're guide/instructor should be aware of? If so please describe.
Submit
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     PO Box 1501 North Conway NH 03860.  603-986-2784 
     (518) 407-KITE   

Hardwater Kiting

122 Depot Rd.

North Conway

,

NH

03860 603-986-2784