When

Tuesday, January 31, 2023 at 4:30 PM EST
-to-
Tuesday, March 28, 2023 at 5:30 PM EDT
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Where

This is an online event.

Contact

Elizabeth Fust
Gathering Strength, Inc.
502-444-0631
gatheringstrengthinc@gmail.com

Positively Fit After Paralysis (Feb-Mar, 2023)

This is a FREE, 8-week class on Tuesday @4:30pm ET. The class includes moderate to vigorous exercise utilizing the upper body and core and is led by a person with a C5 spinal cord injury. It will be live on Zoom starting Jan 31 and ending March 28, 2023. CONSULT YOUR PHYSICIAN BEFORE STARTING ANY EXERCISE PROGRAM.

* Required information

Personal Information

*
What best describes you?
- Spinal Cord Injury Survivor
- Stroke survivor
- Person with paralysis OTHER than stroke or SCI
- Person with disabling condition OTHER than paralysis
- Family member/Caregiver of SCI survivor
- Family member/caregiver of person with OTHER disability
*
Please affirm that you will discuss participating in this class with your physician to confirm that such activity is appropriate for you:
- Yes, I will discuss participating in this class with my physician
- No, I already participate in similar activities without objection from my doctor
* First Name:
* Last Name:
* Email Address:
* Confirm Email Address:
Address 1:
Address 2:
City:
State:
Province:
ZIP Code:
Country:
Phone:
*
How did you hear about the class?
- An email from Gathering Strength
- A forwarded email from a friend or colleague
- A flyer I was given or that I saw posted
- Social media such as Facebook, Instagram, etc.
- Word of Mouth

Custom Information 2

* To help us with reporting to our funders about the reach of our activities, please tell us the zip code you live in or, if you're outside the U.S., the city and country you live in. Thanks.

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When

Where

Contact

Positively Fit After Paralysis (Feb-Mar, 2023)

Personal Information

What best describes you?

Please affirm that you will discuss participating in this class with your physician to confirm that such activity is appropriate for you:

How did you hear about the class?

Release and Waiver

I understand that indicating my consent to these questions will be considered the equivalent of my electronic signature, which is the legal equivalent of my manual signature, on an agreement.

By choosing to participate in this series of online classes, I understand that I am assuming responsibility for any injury that may occur due to my participation.

I understand these classes include moderate to vigorous physical movements and are taught by an experienced instructor(s), nonetheless the possibility of injury (including disability or death) cannot be eliminated.

I hereby release and hold harmless the Instructor(s), Gathering Strength, Inc., and its directors, officers, and agents, from liability for any personal injury which may occur to me due to my participation, whether caused by their negligence or not.

I hereby waive any and all claims, demands, or actions related to my participation in these classes, due to the conduct of the Instructor(s), Gathering Strength, Inc., and its directors, officers and agents.

Custom Information 2