Free Adaptive Fitness Program - Colorado Discover Ability

FREE FITNESS PROGRAM

WHEN: every Wednesday,
from September through April

TIME: 6:15 p.m. - 7:00 p.m. (SHARP!)

No workout on the following dates:

WHERE: Gymnasium, Chipeta Elementary School, 950 Chipeta Ave., downtown Grand Junction (MapQuest)

WHO: children and adults with disabilities, their families and close friends

Parents & caretakers: please don't leave a minor unattended before and after the workout.

PARTICIPATE IN JUST 5 SESSIONS AND GET A FREE "CDA FITNESS TEAM" T-SHIRT!

A ONE-TIME, ANNUAL REGISTRATION REQUIRED

Yes, I want to be physically fit!

ABOUT THE PARTICIPANT

First Name:
Last Name:
Street Address:
City:
State:	ZIP:
Home Phone Number:	(xxx-xxx-xxxx)
Work Phone Number:	(xxx-xxx-xxxx)
Cell Phone Number:	(xxx-xxx-xxxx)
E-mail address:
Date of Birth:	(mm/dd/yyyy)
Gender:	male female

Emergency Contact

First Name:
Last Name:
Phone Number:	(xxx-xxx-xxxx)

PARENT OR GUARDIAN
If under 18, parent or guardian information is required.

First Name:
Last Name:
Address:
Home Phone Number:
Work Phone Number:
Cell Phone Number:
E-mail address:
Relationship:
Comments:

Chapter Member of Disabled Sports USA

Member School of
Professional Ski Instructors of America
and American Association of Snowboard Instructors, Rocky Mountain Division

Proud Partner of
Leave No Trace

Member of the
Colorado River Outfitters Association