Exercise Signup

Individualized Exercise & Weight Training at UD

For People with Disabilities or Limited Ability
One-on-one assistance provided to help 'keep you movin'.

STARTING FALL SEMESTER, SEPTEMBER 1, 2025

PLEASE REGISTER AND WAIT TO BE CONTACTED
SIGN-UP FORM

Signing-up will place you on our e-mail list for notifications of other programs.
Participate in an individualized exercise and weight-training program using Nautilus and/or free weights for strength training and conditioning. One-on-one exercise assistance is provided with staff or student volunteers—designed especially for you. There is NO FEE for this Semester program.

Due to the popularity of the one-on-one staff/volunteer assistance, there may be a waiting list. Select 1 or 2 days weekly to exercise with assistance. The program runs from September - May. Select ALL times that you are available so we can pair you with an assistant. Once paired, your 2 exercise sessions will be at the same time each week.

When: Fall and Spring Semesters
September - May: Each calendar year (indiviual exercise is scheduled by appointment with student volunteer coordinated with your schedule)

Where:
University of Delaware, Bob Carpenter Sport Center (Little Bob)*
Outdoor Recreation Resource Center, Rm. 005
26 N. College Ave., Newark, DE 19713

*The center is at the back of the parking lot across from McDowell.
Join the Exercise Program?*

YesNo
How Many Sessions a Week?*

1 Session2 Sessions
First Name*
Last Name*
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Cell Number*
E-mail*
Available Times

Select all available times. One hour sessions will be scheduled twice a week in your chosen time slot(s).
Exercise Sessions*

I am available 8am - 11am‎I am available 11am - 2pm‎I am available 2pm - 5pmI am available 5pm - 8pm‎
Optional Message
Optional Message - Please indicate days or times you are not available to exercise.
To better serve you, please check boxes that apply. This information will help us design future programs.
Condition

Amputee‎Brain Injury‎CancerCerebellar AtaxiaCerebral Palsy‎CIDPFibromyalgia‎Hearing Impaired‎Metal PoisoningMS‎Paraplegia‎Parkinson’s‎Quadriplegia‎Rheumatoid Arthritis‎SarcoidosisSpinal FusionStroke‎Visually Impaired‎Other
Gender*

Male‎Female
Age*

18 - 19‎20 - 29‎30 - 39‎40 - 4950 - 59‎60 - 69‎70 - 79‎80 - 89‎
Are you a Military Veteran?*

YesNo
Do you use any mobility aides?*

cane‎walker‎manual wheelchair‎power wheelchair‎no, I do not‎
Need assistance to park your car?

Please indicate if you need assistance parking your car. Parking is limited. Participants can drive and park in front of the CSB (Little Bob) entrance and a student will greet you and park your car. They will place a temporary UD Handicap Placard in your car and park in a designated parking space. NOTE: Even if you have a handicap placard, the University will still require a day permit to park or you will be ticketed.
If you are parking your own car, you will need a day pass from the University. Will you be parking your own car? If "yes," enter make and color of car below.*

Yes, I doNo, I do not
Make of Car?
Color of Car?
Will you be taking Paratransit?*

YesNo
Will someone be dropping off?*

YesNo
Permission Request

For the exercise program to run effectively and safely, we need to share your information on this form with the exercise program's student volunteers who will assist you.
Permission to share your information?*

Yes, you may shareNo, you may not share
By submitting this sign-up form, you elect to participate in this Yes U Can program and you agree to allow the Yes U Can Corp. to use photographs and/or video that may be taken of these sessions for marketing purposes, e.g. website, Facebook, brochures, etc.
Website: YESUCANUSA.ORG
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