Urban Aboriginal Healthy Living Program

ᓭᕐᕓᒉᔅ

“Empowering individuals to live healthy, active lifestyles.”

The program is community-based and inclusive to all.

The objective is to work towards achieving the following desired health outcomes and wellbeing of you the individual.

NUTRITION– Providing nutrition education and skills to participants. They can include healthy cooking classes, understanding nutrition, benefits of healthy eating and grocery shopping.
SPORT ACTIVITIES– Sports are an opportunity to improve both physical and mental health, as well as social health.
PHYSICAL FITNESS ACTIVITIES– Focusing on cardiovascular health, this component includes exercise and activities that will increase heart rate and breathing and in turn improve physical fitness and well-being.
PHYSICAL RECREATIONAL ACTIVITIES– Provides benefits to physical, mental, and social health, and promote adopting a more physically active lifestyle.
SMOKING CESSATION/SMOKING-FREE LIVING– Activities geared toward promoting smoke-free lifestyle, prevent smoking, and support programs for those who have quit smoking, and role models for smoke free living.
YOUTH LEADERSHIP– Develop comprehensive program aimed at development of leadership roles for our youth.

The Healthy Living Program can help you achieve your lifestyle goals!

First Name

Last Name

Date of Birth

Phone

Address

Street Address City Postal Code

If Under 18 years old please provide Parent/Guardian Information:

First Name Last Name

Phone

Consent

I agree to the Release of Liability, Waiver of Claims and Indemnity Agreement.

I have read and understand the rules and safety provisions established for the Program. I have had the opportunity to discuss with the Thunderbird Friendship Centre any risks, dangers, or hazards to my person resulting from participation in the Program.

I am aware that my participation in the Program is voluntary. I freely accept and fully assume all such risks, dangers and hazards, the possibility of delay or inconvenience, Program cancellation or change or the potential loss of personal property, injury and death.

In consideration of the Thunderbird Friendship Centre allowing my participation in the Program, I agree as follows:

1. To release and discharge the Thunderbird Friendship Centre, its directors, officers, agents and employees, from all liability to me, my personal representatives, heirs, and next of kin, for all losses, damages and costs including but not restricted to legal costs, and to waive any claim or demands on account of any injury to me, my death or any damage to or loss of any property of mine, or costs arising out of my participation in the Program even though such loss, damage, injury or costs may have been caused by the negligence of the Thunderbird Friendship Centre.

2. To certify that I am physically fit and able to safely engage in the Program.

3. That I agree to comply with the rules and safety provisions established for the Program.

4. To indemnify and hold harmless the Thunderbird Friendship Centre from any loss, liability, damage or costs that may arise from my acts or omissions during participation in the Program.

5. That in the event of any accident or sudden illness, the Thunderbird Friendship Centre has my consent and permission to have performed on me whatever medical emergency treatment may be deemed necessary.

6. That this Agreement shall be effective and binding upon my heirs, next of kin, executors, administrators, assigns and representatives in the event of my death or incapacity.

Message

ᓭᕐᕓᒉᔅ

Urban Aboriginal Healthy Living Program

ᐊᑦᒃᔾᐁᕐ

Thunderbird Friendship Centre

Programs & Services

Geraldton Offices

Longlac Offices