BYU-IDAHO FIT-4-LIFE APPLICATION
PARTICIPATION CRITERIA/COMMITMENTS

We welcome you to the BYU-Idaho Fit-4-Life Program. We hope this semester will be your time and season for meaningful lifestyle change. A change directed toward making a happier, healthier you, that’s more capable of going, doing, and becoming. You have our commitment, as those who effectuate the Fit-4-Life Program, that we will do our best to help you improve your level of fitness and overall quality of life. We look forward to working with you in this very worthy effort.

*Please read thoroughly

FIT-4-LIFE PRTICIPATION ELIGIBILITY REQUIREMENTS:

  1. Be affiliated with BYU-Idaho and possess a valid BYU-I number (employee, employee spouse, student, student spouse. No children under the age of 18.
  2. If needed, please schedule an appointment with your physician (The BYU-Idaho Health Center can provide this service, if you have BYU-Idaho Health Insurance). The Par-Q sheet below will explain.
  3. Be willing to adhere to all program commitments and requirements (calendar is provided below).
  4. There will be a $25.00 fee at the time of acceptance to the program, which will be charged to your I-Card. (Non-Refundable)

APPLICATION ACCEPTANCE:

  1. Application completed and dropped off at the Wellness Center Hart 152. Dr. Signature, if needed.
  2. Applications may be turned in one week before the end of the semester for participation of the following semester.
  3. There will be a cap placed on the number of participants accepted to the program (usually by the fourth week of the semester or sooner).

WEEK ONE/TWO OF THE SEMESTER:

  1. Folders (with participant’s names on them) will be made and kept in the Fitness Center. Workouts (according to participants desired fitness goals) will be placed in each folder.

II.  Meet with a Personal Trainer to discuss fitness goals.

  1. Meet with a nutrition consultant in the Wellness Center to calculate your customized Nutrition Plan (not required, but encouraged). Contact the Wellness Center at (208)-496-7491 or go to Hart 152 to make an appointment.
  2. Initial Assessments and blood draw (not required but recommended). Appointments can be made by contacting the Wellness Center.

WEEKLY COMMITMENTS:

  1. Contact a Personal Trainer and be willing to train on your own, or with a group, to reach your goals. Report progress to the trainer; they will make recommendations on how to be successful with your goals.
  2. Meet weekly with a nutrition consultant from the Wellness Center to review personal goals and change accordingly.

AS FIT-4-LIFE COMES TO A CLOSE:

  1. Participate in your final health and fitness assessment, if you choose. Appointments can be made by contacting the Wellness Center.
  2. Participate in the Fit for Life CLOSING SOCIAL (If one is being held)

ADDITIONAL INFORMATION:

  1. Throughout the semester, there will be Wellness Workshops held with various speakers and topics. We encourage all to attend, seeing as it may pertain and be applicable to your personal goals.

FIT 4 LIFE APPLICATION
PERSONAL INFORMATION

*Please fill out the application with as much detail as possible. Answer all questions honestly and to the best of your ability.All of the following information will be kept confidential. Please return this form to the Wellness Center in the Hart building 152.

Name: ______
Address: ______
E-mail Address: ______Phone Number: ______I#______NOTE: If you are a spouse of a student____ or spouse of an employee____ please submit your spouse’s I#______Spouse I# will be charged. Gender M___ F___ Age: _____T-Shirt Size______
Marital Status: Single___ Married ___Full Time Student ____Off Track___ Matriculating Student ____ Employee____ or Employee Spouse____
What is your GOAL for being in the program?

_____Increase muscular size (hypertrophy)

_____Increase muscular strength

_____Increase muscular endurance

_____Improve my cardiovascular fitness

_____Weight loss

_____Other (Please specify) ______
If accepted into the program you will be available to meet with your trainer and commit to working out on your own or with a group.
Are you prepared to commit to the program? Initial ______

Comments:

**I know that my weight/initial assessment and medical records will be seen by the BYU-Idaho Wellness Center, student leaders, employees in the program, other contestants and interns within the program. (Initial) _____ I am willing to release all results for publicity purposes (Yes) (No)

***Making even small positive lifestyle changes yields rewards in not only health and fitness, but all around wellness. To honor that fact, a T-shirt and a water bottle will be awarded to all contestants that make an effort to honor their goals for the duration of the semester. Contestants are encouraged to do the best they can and encourage their fellow contestants to do the same. This will be awarded AT THE CLOSING SOCIAL.

Participant Signature: ______

I certify that I have a valid health insurance ______

PAR-Q:

Yes No Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes No Do you feel pain in your chest when you do physical activity?

Yes No In the last month have you had pains in your chest when you were not doing physical activity?

Yes No Do you have a bone or joint problem (for example back knee, or hip) that could be made worse by a change in physical activity?

Yes No Is your doctor currently prescribing drugs or water pills for your blood pressure heart condition?

Yes No Do you know of any other reason why you should not do physical activity?

* If you answered YES to any of these questions above please talk with your doctor before you submit your application.

1.  If you are currently on medication for high blood pressure, ask what the doctor’s recommendations are regarding exercise.

* Please note that if your health changes so that you now answer YES to any of the above question, tell your fitness consultant and ask your doctor whether or not you should change your physical activity plan.

*If needed: Take this to your Dr. for approval. Doctors Approval of Participation: In my opinion this person is healthy enough to participate in a weight loss and exercise program.
Doctor Signature: ______

Address: ______


Date of service: ______

If you need a fax number: (208) 496-6130

ASSUMPTION OF RISK, PERSONAL RESPONSIBILITY AND RELEASE AGREEMENT

I know and recognize that participation in the wellness program conducted by BYU-Idaho is done on a voluntary basis without compulsion or coercion. I know that there may be dangers and hazards associated with participation and assume the associated risks, including but not limited to: heart problems, injury to vital organs, broken bones, head injuries, joint injuries, strains, sprains, bruises and other trauma which may be caused by physical exertion, falls, collisions with other athletes/objects or other accidents or incidents associated with wellness activities. I acknowledge that these hazards could cause physical or emotional harm or even death.

I further acknowledge that the decision of whether or not to participate in any given activity or event is my own personal decision based upon my own assessment of my physical and mental ability to participate and is not the decision of anyone else. I understand that the consultants are for encouragement and motivational purposes only. I am ultimately responsible for my own activity level. I also understand that it is my personal responsibility to report any significant injury resulting to me from my participation to the certified BYUI Athletic Trainer.

Knowing the risks , understanding my responsibility and in consideration for being permitted to participate, and as an inducement to BYU-Idaho to permit me to participate, I hereby, for myself, my heirs, executors, administrators, or anyone else who might claim on my behalf, covenant not to sue and waive, release and discharge BYU-Idaho, its agents, officers, volunteers, and employees from any and all claims or liability for death, personal injury or property damage of any kind or nature, and any other claims whatsoever arising out of or in any way connected with, my participation in this activity, even though liability may arise out of carelessness on the part of BYU-Idaho, including its officers, employees, and volunteers


This release extends to all claims of every kind or nature whatsoever, foreseen or unforeseen, known or unknown.

THE UNDERSIGNED, BY MY SIGNATURE BELOW AFFIRMS THAT I HAVE CAREFULLY READ THIS ASSUMPTION OF RISK AND RELEASE AGREEMENT AND THE OTHER TERMS; I UNDERSTAND ITS CONTENT AND PURPOSES, AND I VOLUNTARILY AGREE TO ALL THE TERMS SET FORTH ABOVE.
Contestant Signature: ______Please submit this page with you application.

Fit for Life Exercise Recommendations

NOTE: Recommendations are based on research cited in American College of Sports Medicine (ACSM) Position Stands.

GENERAL STATEMENT ABOUT TRAINING FOR WEIGHT LOSS:

Individuals with large body masses and high percentages of body fat will likely need a great deal more volume of training than a person training to maintain optimal cardiovascular health. Furthermore, once a formerly overweight person achieves the weight loss, maintenance of the new weight appears to be enhanced with greater volume than what it typically recommended for general cardiovascular fitness.

Medical Evaluation

  1. Participants should provide a documented medical clearance from a licensed physician prior to participation that includes an evaluation of cardiopulmonary risk factors and musculoskeletal health.
  2. Medical professional should be aware of the scope of the Fit4Life program during the evaluation.
  3. Participants should be informed of the risks of participation in this program.

Supervision

  1. Participants have the option of having a trainer/coach to assist with their workout planning and training sessions
  2. Trainers/coaches may be in attendance at exercise sessions, but participants may also perform any portion of the program prescribed or implied without direct supervision
  3. It is understood that trainers/coaches are students not professionals.
  4. Trainers/coaches will have been documented to have demonstrated an understanding of ACSM guidelines associated with this program and a commitment to adhere to those guidelines.

Cardiovascular Exercise

  1. Participants should train at moderate intensity
  2. Level 6 on a scale of 1-10 (with 10 being the hardest)
  3. Level 6 is a level that will allow participants to carry on a speaking conversation
  4. Training duration in the first weeks can be as few as 10 minutes per session and may be longer depending on the individual’s response.
  5. Training frequency should progress to 5 to 7 days per week. Start at your own fitness level.
  6. Mode of exercise can be anything tolerable to the participant. Common recommendations for beginners include walking. Cycling and swimming are common modes as well.
  7. As fitness improves participants may also benefit from more intense physical activity—i.e. overweight/obese individuals have performed cardiovascular exercise at intensities that were higher than allowed them to carry on a speaking conversation.

Cardiovascular Goals

  1. Progress to a minimum of 150 minutes per week of moderate-intensity activity.
  2. Greater weight loss (and prevention of weight regain) will be more likely at 250-300 minutes of moderate-intensity physical activity.

Resistance Exercise

  1. Participants should perform eight to 10 strength-training exercises and 8-12 repetitions for two sets. Participants may elect to perform more sets and/or reps as individual needs dictate.
  2. Intensity and volume should be systematically altered to improve fitness.
  3. Initial training frequency should be two times per week with a minimum of 48 hours between training sessions.
  4. The mode of training can be anything tolerable to participant.
  5. Initially inexperienced weight trainers may benefit from performing machine-based exercises that isolate a muscle group and reduce the balance demands.
  6. Progress to free weight exercise and skill and fitness improves.

Resistance Goals

1.  Participants will perform resistance exercise 2 times per week and may progress to three or more times per week by the end of the program.

2.  Loads will progress to the point where the participant uses loads that fully challenge him or her for 8-12 repetitions (e.g. participant chooses a weight he or she can only lift 10 times for a 10- repetition set, not a weight that would allow 15-20 reps)