SPIRIT Fitness Demo Enrollment Form
Please select up to 2 (two) free SPIRIT Fitness classes that you would like to attend. Feel free to select a class at either location.
Classes are designed to be fun, interactive, and inclusive for people of all abilities.
Classes offered at: 3239 E 2nd Ave, Denver, CO 80206
Monday, 10/6 at 5pm
Wednesday, 10/8 at 10am
Wednesday, 10/8 at 5pm
Classes offered at: 5984 S Prince St # 101, Littleton, CO 80120
Sunday, 10/12 at 10:30am
Sunday, 10/12 at 2pm
If you would like to attend a class but cannot make any of the ones listed above, please share the ideal class day/time/location that would work best for you:
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Member Name
*
Member Date of Birth
*
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Month
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Day
Year
Date
Representative Name (if different than Member)
Best Contact Email Address
*
example@example.com
Best Contact Phone Number
*
Please enter a valid phone number.
Zip Code
*
Please enter your zip code
Organization Affiliation (if applicable)
Emergency Contact Name
*
Emergency Contact Relationship
*
Parent
Guardian
Spouse / Partner
Sibling
Child
Other
Emergency Contact Phone Number
*
Please enter a valid phone number.
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Please select all that apply:
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The Member has a heart condition and should only perform physical activity recommended by a doctor.
The Member experiences chest pain during physical activity, or in the past month, has experienced chest pain when at rest (not exercising).
The Member faints or loses balance due to dizziness.
The Member has a bone or joint problem that could be made worse by a change in physical activity.
NONE OF THE ABOVE
Please share further details regarding the selection(s) made above
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Has the Member been cleared by their doctor to participate in community fitness programs?
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Yes
No
Please list any relevant physical injuries, past surgeries, or general concerns:
Please share any sensitivities or relevant behaviors that the instructor should be aware of:
Please select all that apply
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The Member has a tendency to leave a program or location without notice.
The Member requires assistance with personal care such as going to the bathroom.
The Member requires consistent support staying engaged or following group instructions during activities.
The Member has a dedicated 1:1 support person in other programs, school, or community activities.
The Member exhibits behaviors that may put their own safety or the safety of others at risk.
NONE OF THE ABOVE
SPIRIT Club requires that the Member be accompanied by a caregiver for the duration of class. Can you confirm that a caregiver will be present and attentive throughout the class?
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Yes, a caregiver will be present and attentive to the Member throughout the class.
By signing below, I / Member agree to the TERMS & CONDITIONS linked above.
*
Please type the name of the person signing:
*
If signed by a someone other than the Member, please specify your relationship to the Member:
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