3) Physician Approval (If You Answered Yes on at Least 1 Question on PAR-Q)

Walking 101

WALKING is an ideal low impact exercise! It is easier on the joints than high impact exercises and you can get a good workout by walking. All it takes is a small time commitment, good shoes and socks, and the will to walk.

REQUIREMENT: If you are just beginning an exercise routine, it is strongly suggested that you see your primary care physician for an exam prior to beginning any type of exercise program. This visit will also provide you with a baseline of your health. The following forms are required for Walking 101.

1) Registration 2) PAR-Q 3) Physician Approval (if you answered yes on at least 1 question on PAR-Q) 4) Be committed to 12 weeks of walking with this class 5) There is no age limit but all children must be accompanied by a parent or adult 6) Registration and Fitness Assessment will be conducted a week before classes begin. 7) It is recommended that you join the Wings Fitness Program a. Incentive based program b. Race registration is free to Wings members

THE RUN/WALK PHILOSOPHY:

 Our program is safe and gradual in design. It’s been proven by hundreds of women and men just like you and it truly takes the intimidation out of being active.

ABOUT THE WALKING PROGRAM:

 Our goal is to help you develop a passion for walking and getting FIT and at the same time, improve your health, develop a more positive self-image, boost your energy level, and enhance your overall quality of life.  Our class is not a competition. Healthy Nation is here to assist you in getting into a schedule for regular walks. An exercise as simple as walking has many benefits!

BENEFITS: 1) Reduces the risk of Heart Disease 2) Lowers your cholesterol 3) Maintains healthy bones and muscles 4) Boosts your energy level 5) Fights the aging process 6) Relieves pressure and stress from your life 7) Improves your appearance. You’ll be looking good!

WALKING IS CHEAPER THAN THERAPY!!!

Plan Your Time Well

Depending on the “walk time” prescribed for a specific day, plan for at least an hour for your “walk workout”. As the time increases, you may need to plan for longer than an hour to complete your workout.

CLASS DETAILS: 1. This organized walking program offers 2 coached walks each week: Tuesday at: Thursday at: 2. This program is set up for 3 walk sessions per week. Therefore, you will be “on your honor” to do a third walk on the weekend. 3. Be sure to hydrate before and after your walk. We will provide water for your 2 coached walks. 4. Be sure to get a good pair of walking shoes before starting this program.

Start Date: January 30, 2017

Time: 5:30

Location: Norris Park

PROGRAM DURATION: 12 JanuaryWeeks 30th thru April 24, 2017

*Goal Event Red Fern 5K (3.1 miles) Saturday April 29, 2017 in Tahlequah, OK You must be a Wings member to receive free2 registration to this race. Otherwise, you must pay for the registration fees. This cost is typically in between $15.00- $25.00 STEP 2 IT

REGISTRATION FORM

First Name: ______Last Name: ______

Address: ______

City: ______State: ______Zip Code: ______

Phone: ______Cell: ______Gender (circle one): M F

E-mail: ______Date of Birth: ______Age: ______

Emergency Contact Name: ______Phone: ______

What time would best fit your schedule?  6:30 a.m.  5:30 p.m.  6:00 p.m.  Other______

Informed Consent Statement: I understand that my participation with Walking 101 involves physical exercise that may be strenuous at times. This activity involves risks and injuries that may occur during my physical fitness activity. I understand and agree that I should be in adequate physical condition or acquire a recommended physician clearance before engaging in this fitness and exercise program.

In the event of illness, injury or accident during my fitness participation in Running 101, I or my parent/guardian if I am a minor child, hereby release, hold harmless, discharge and agree not to sue the Cherokee Nation, partner school systems and organizations, their employees or representatives, and owners/lessors of premises from all liabilities or damages brought in litigation by other persons or parties on behalf of participants. This includes, but is not limited to liability of illness, injury or accident, lost, stolen or damaged property, or other risks that are not

3 foreseeable which may occur during my participation.

If illness, injury or accident occurs requiring immediate medical attention, I or my parent/guardian If I am a minor, authorize sponsoring representatives to obtain necessary medical treatment for my condition.

I have read this form and understand that there are inherent risks associated with any physical activity and recognize it is my responsibility to provide accurate and complete health//medical history information. Furthermore, it is my responsibility to monitor my individual physical performance during any activity.

Participant Signature:______Date:______

Parent/GuardianSignature:______Date:______(Must be signed by Parent or Guardian if child is under the age of 18)

Physical Activity Readiness Questionnaire

(PAR-Q)

Name______Gender ______

Age______Date of Birth______Phone #:______

Mailing Address______

What is a Par-Q? The Par-Q is a simple screening tool and necessary before beginning this exercise program. The purpose is to clear for exercise or refer for further screening. The objective is not diagnostic, but to determine risk: orthopedic, cardiovascular and chronological.

YES NO Please read each question carefully and check the appropriate answer.

______1) Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

______2) Do you feel pain in your chest when you do physical activity?

______3) In the past month, have you had chest pain when you were doing physical activity?

______4) Do you lose your balance because of dizziness or do you ever

4 lose consciousness?

______5) Do you have a bone or joint problem that could be made worse by a change in your physical activity?

______6) Is your doctor currently prescribing medication for your blood pressure or heart condition?

______7) Do you have insulin dependent diabetes?

______8) Do you know of any other reason why you should not engage in physical activity?

If you answered “Yes” to one or more questions, you MUST complete a physical examination with physician consultation i.e. LETTER TO PHYSICIAN before becoming more physically active.

If you answered “No” to all questions, you have reasonable assurance that you can safely increase your level of physical activity on a gradual basis. A physical examination is not required.

I have read, understood and completed this Par-Q form. I am aware that there are inherent risks associated with any physical activity and recognize that it is my responsibility to provide accurate health and medical history information.

Participant Signature______Date______

Parent/Guardian Signature______Date______(Must be signed by Parent or Guardian if child is under 18 years of age)

Letter to Physician

Dear Physician:

Your patient ______, wishes to become a member of the Wings Physical Activity Program. This self-paced program involves progressive resistance training, flexibility exercises, and a cardiovascular routine, increasing in duration and intensity over time.

After completing a Physical Activity Readiness Questionnaire (PAR-Q) and identifying a medical condition, we agree to seek your advice before participation in this physical activity program.

A physical examination is required, so please make recommendations or restrictions that are appropriate for your patient.

Thank you.

Please check one of the following that apply. I am not aware of any contradictions toward applicant participation in this physical activity program.

5 The application should not engage in the following activities:

I recommend the applicant not participate in this physical activity program.

Physician Signature:______Date:______

Physician Name (print):______

Clinic/Hospital Name:______

Address:______

Phone #:______

Cherokee Nation/Healthy Nation Training Schedule Walking 101 Goal Event: (Put Cherokee Nation Race here)

6 Warm-Up Brisk Walking Cool Down Run Total Post Walk Total Week 1 Stretch ______5 min. 15 min. 5 min. 25 min. 5 min. 30 min.

Week 2 ______5 min. 15 min. 5 min. 25 min. 5 min. 30 min.

Week3 ______5 min. 20 min. 5 min. 30 min 5 min. 35 min.

Week 4 ______5 min. 20 min. 5 min. 30 min 5 min. 35 min.

Week 5 ______5 mi. 25 min. 5 min. 35 min. 5 min. 40 min.

Week 13 Goal Event ______5 min 50 min. 5 min. 60 min 5 min. on Saturday 65 min.