Winter Snowshoe 2023 Registration

Nordic Walkfit – Winter 2023 Snowshoe & Hiking Registration

WINTER 2023 - Snowshoe classes will start January 9, 2023 and run for 10 weeks until mid March. We are organizing 60 minute Beginner and 90 minute Intermediate & Advanced classes most mornings starting at 10AM. One Lead & Support Instructor to a maximum of 15 participants per class. Join us for Fun, Fitness, Friends and Fresh Air throughout parks and wooded trails in West Ottawa. Enjoy a safe, physically active and social environment outdoors maximizing enjoyment of our Canadian winters. For more info or questions, contact: nadine.imbleau@gmail.com 613-867-2744
Name*

First NameLast Name
E-mail*
example@example.com
Address*

Street Address

Street Address Line 2

CityProvince

Postal Code
Cell Phone Number*

Area CodePhone Number
Home Phone Number

Area CodePhone Number
Emergency Contact Name*
Person we should contact in case of an emergency
Relationship to Participant*
Emergency Contact Phone Number*

Area CodePhone Number
Please select the number of classes you plan to snowshoe with us this Winter. Pricing includes GST/HST.*

1X a week for 10 weeks (10 classes) $1502X a week for 10 weeks (20 classes) $2503X a week for 10 weeks (30 classes) $300Partial season: 7 classes over 10 weeks $135Drop-In Class $20/class - Dependent on available capacity. Contact Nadine at nadine.imbleau@gmail.com to schedule a class date you can possibly attend.
Please select which Class Day(s) & Time(s) you plan to attend. Classes are held in Kanata/Stittsville and/or Barrhaven West Nepean NCC Greenbelt trails ALL CLASSES START AT 10AM.*

MONDAY Beginner Intermediate 60 minutesMONDAY Advanced 90 minutesTUESDAY (Barrhaven) Beginner/Intermediate 60 minutesWEDNESDAY Beginner/Intermediate 60 minutes** NOW FULL** WEDNESDAY Advanced 90 minutesTHURSDAY (Barrhaven) Beginner/Intermediate 60 minutesFRIDAY Beginner/Intermediate 60 minutesFRIDAY Advanced 90 minutesSATURDAY Beginner/Intermediate 60 minutes** NOW FULL** SATURDAY Advanced 90 minutesDROP-IN Class $20/class - Contact Nadine at nadine.imbleau@gmail.com when you'd like to attend a drop-in class (pending available capacity)
Payment by*

ChequeInterac Bank e-transfer
Please mail your cheque to Nordic WalkFit c/o Nadine Imbleau-Redman 542 Pennycross Lane Carp, ON K0A 1L0.
Please use your bank's online banking app or website to make your Interac E-transfer to nadine.imbleau@gmail.com (automatic bank deposit is set-up to Nordic WalkFit account with this email address)
- Please include in the notes area the name of the course and the name of the person registered, to help us connect payments to registrations.
Health Questionnaire with Par Q

For your safety and enjoyment, we require every participant to submit a Health Questionnaire (Par Q) upon registration to ensure you are registering for an appropriate fitness class level. Each participant must submit the Health Questionannaire with Par Q below.

Please inform Nordic WalkFit of any changes to your health status at any time while registered and participating in a class.

We also ask that each participant fill in an Emergency Contact Card and bring it to every class, so that it will be available in case of any emergency.

Click the link above to display a printable form for the card in a new browser window or tab.
A/ Do you have any acute or chronic conditions that should be taken into account in determining the class most suitable for you? (please select any that apply)*

1. Asthma/ Lung Disease2. Diabetes3. Osteoporosis4. Rheumatoid Arthritis5. Osteoarthritis6. Frozen shoulder or tennis elbow7. Visual Limitation8. Pain in any area9. Balance, gait or coordination limitations10. Heart DiseaseNone of the above
Birth Date?
Age?*

B/ Par Q – (check the appropriate response and read all questions carefully)*

	Yes	No
1. Has your Doctor ever told you that you had a health problem? If yes, please provide additional information below.
2. Has your Doctor ever told you that you have high blood pressure?
3. Have you ever had a stroke or heart attack?
4. Have you ever had pain in your chest?
5. Do you ever feel faint or have dizzy spells?
6. Have you had surgery in the past 6 months?
7. Do you have any bone or joint problems?

Please provide additional health information if you answered YES to any of the questions in the Health Par Q.

0/200
Urban Poles are available at each class for borrowing if participants do not have their own poles.

YES - I will need to borrow Urban Poles during class.
How did you learn about Nordic WalkFit?*
Comments or Questions for us?

0/200
Thank You!

Your spot is "on reserve" upon pressing the REGISTER NOW button. Confirmation of your class and spot will be upon receipt of payment. We look forward to enjoying Fun, Fitness, Friends and Fresh Air this Winter 2023! www.nordicwalkfit.com For more information or questions, contact: nadine.imbleau@gmail.com 613-867-2744
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Nordic Walkfit – Winter 2023 Snowshoe & Hiking Registration

Health Questionnaire with Par Q

Thank You!