MOVE by GoodLife Kids Barrie Program

Thank you so much for your interest in joining MOVE by GoodLife Kids Program in person at GoodLife Fitness Barrie Commerce Park, located at 42 Commerce Park Drive!

MOVE by GoodLife Kids is a free physical activity and fitness program exclusively designed for kids and youth 12 to 21 years with autism and intellectual disabilities that focuses on physical literacy and building a love of fitness.

MOVE Coaches lead the program. Coaches are fitness professionals and are trained to provide successful physical activity and fitness programming for individuals with autism and intellectual disabilities.

Please use the form below to apply. Please note there are limited spots available and completion of this form does not guarantee the Participant a space in the MOVE program.

IMPORTANT: If you are looking to register for our virtual program please use the link at goodlifekids.com/move

A parent or guardian is required to fill out this form for anyone under the age of 18.*
- I am a parent/guardian/caregiver
- I am a participant aged 18 or over
Which MOVE Class would work best for you?*
How did you hear about MOVE
- From GoodLife Kids Foundation
- From GoodLife Fitness
- From a friend/word of mouth
- From an internet search
Participant Information
Participant's Full Name*
This helps us connect your agreement to the correct Participant.
Participant's Email Address
Participant's Date of Birth*
MM slash DD slash YYYY
Participant's Address*
Street Address City Province Postal Code
Allergies
Please list any known allergies.
Shirt Preference
100% polyester athletic t-shirt
Youth Shirt Sizes
- XS
- S
- M
- L
- XL
Men's Shirt Sizes
- XS
- S
- M
- L
- XL
Lady's Shirt Sizes
- XS
- S
- M
- L
- XL
Caregiver Information
Primary Caregiver Name
First Last
Your Relationship to Participant*
Primary Caregiver Email*
Primary Caregiver Phone Number*
Please note that a caregiver is required to be present for each MOVE class. Before proceeding with the rest of the application lease confirm that a caregiver can be present.*
- Yes
- No
Will the primary caregiver listed above be the caregiver who will be attending the MOVE Classes?*
- Yes
- No
If no, please provide the full name, email address, and phone number for the caregiver who will attend the MOVE class
Emergency Contact*
Please provide the NAME and PHONE NUMBER of someone not attending the MOVE program that we can contact should we need to get ahold of them for any reason.
Participant Profile
How is the Participant currently incorporating physical activity into their life?*
What are their attitudes towards physical activity and fitness?*
What special interests to they have?*
What motivates the Participant to continue to work through challenging situations?
Do they have any fears or dislikes?
Tell us more about the Participant.
Is there anything that we have not covered that you'd like to share that may be of interest to ensure they have the most supportive and engaging MOVE class experience.
Availability
Our MOVE Program Specialist will reach out to discuss next steps. Please list times that typically work best for you to be available for a 10 minute phone call.*
MOVE Forms & Waivers
This webform will take you through the following forms and waivers for electronic signature. These are required and must be completed in order to participate:
1. Waiver of Liability and Release (Required)*
2. Physical Activity Readiness Questions (Required)*

The Liability and Release waiver and Physical Activity Readiness Questions must be electronically signed by a parent/caregiver for anyone under the age of 18.

You will receive a copy of the completed waivers immediately by email. If you do not receive it, please check your junk mail folder.
MOVE Participation Waivers
1. Waiver of Liability and Release (Required)**
By my participation in MOVE by GoodLife Kids Program (“the Program”) hosted at a GoodLife Fitness club, I hereby acknowledge and agree with the following:

1. The fitness activities, exercise and participation in the Program may expose participants to risks and hazards, some of which are inherent in the very nature of the fitness activities and exercise itself, others which result from human error and negligence and, as a result of such risk I, as a participant, may suffer serious personal injury (even death). I understand that the Foundation, GoodLife, the organizers of the Program and their respective officers, directors, employees, independent contractors, agents, affiliated clubs, sponsors, and volunteers (collectively the “Releasees”) do not assume any responsibility whatsoever for my safety during my participation in the Program. I nevertheless freely and voluntarily assume all the aforesaid risks and hazards, and the possibility of personal injury, death, property damage or loss, resulting therefrom and, I assume all risks of injury to myself or others including any illness or medical condition and any NEGLIGENCE ON THE PART OF THE RELEASEES, INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN THE PROGRAM.

2. I agree on my own behalf (and on behalf of my personal representatives, heirs, estate trustees or assigns) to: (a) waive any and all claims that I have or may have in the future against the Releasees and I release, indemnify and discharge Releasees from any and all claims or causes of action (known or unknown) which I may have arising out of my participation in the Program, DUE TO ANY CAUSE WHATSOEVER, INCLUDING NEGLIGENCE, BREACH OF CONTRACT, OR BREACH OF ANY STATUTORY OR OTHER DUTY OF CARE ON THE PART OF THE RELEASEES, AND FURTHER INCLUDING THE FAILURE ON THE PART OF THE RELEASEES TO TAKE REASONABLE STEPS TO SAFEGUARD OR PROTECT ME FROM THE RISKS, DANGERS AND HAZARDS OF PARTICIPATING IN THE PROGRAM; and (b) to indemnify and save the Releasees harmless from any and all claims or causes of action (known or unknown) brought against the Releasees by any party arising out of my actions, including my negligence, while participating in the Program.

3. I acknowledge that I may submit photographs or videos of my participation in the Program and that the Foundation may take photographs or videos during the Program that my image, likeness, voice and/or performance may be captured in such photographs and videos. I hereby unconditionally and irrevocably consent, authorize and grant to the Foundation, its successors, assigns and licensees, all necessary authority, right and license to use any photographs or videos containing my image (collectively “Photographs”) throughout the world without limitations or restrictions and in their sole discretion, including without limitation: reproduction in all media, publication, display, exhibition for promotion, advertising, trade, art, or illustration. I confirm that the Foundation does and will forever own and retain all right, title and interest throughout the world in the Photographs, subject only to any assignment or license it may grant in its sole discretion. I hereby irrevocably and unconditionally assign to the Foundation and its licensees, successors and assigns all right, title and interest (including privacy, personality, moral and publicity rights) I have or may acquire in my image, likeness, voice and performance as contained in the Photographs and waive in favour of the Foundation and its licensees, successors and assigns all non-transferable rights and interests in the Photographs. I HEREBY RELEASE THE RELEASEES from any and all claims which I may now or in the future have relating to the ownership, reproduction, display, distribution or other use of the Photographs and will hold them harmless in relation to complaints, actions, causes of action, liabilities, damages, losses, legal fees, costs and expenses of any nature and kind whatsoever incurred by any of them by reason of any claim relating to any damage whatsoever in respect of any act or omission in respect of the Photographs or any exploitation of the Photographs or this Agreement.

4. If I am the parent or guardian of a minor participant (“the Minor”), I am hereby providing my express consent to the Foundation and GoodLife to allow the Minor to participate in the Program. By signing below, I am agreeing to the terms and conditions of this Release Agreement on my own behalf and/or on behalf of the Minor, as their parent or guardian. I acknowledge and agree that my heirs, executors, administrators and assigns will also be bound by this Release Agreement.
I have read the Waiver of Liability and Release Agreement above, and by clicking this box I do hereby consent to the terms and conditions listed herein. (Required)
Caregiver Consent*
- On behalf of the Caregiver, I have read the Waiver of Liability and Release Agreement above, and by clicking this box I do hereby consent to the terms and conditions listed herein. (Required)
Your Full Name*
Please enter your full name to confirm your electronic signature.
Today's Date*
MM slash DD slash YYYY
Your Email Address*
We will email you a copy when completed
Participant Declaration
If in doubt after completing the questionnaire, consult your doctor prior to physical activity.
Has the Participant had (within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem or other medical conditions that could be made worse by becoming more physically active?*
- Yes
- No
Has the Participant's doctor ever said that they should only do medically supervised physical activity?*
- Yes
- No
PARTICIPANT DECLARATION*
If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian or care provider must also sign this form.
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
By clicking this box, I declare that I have read the Participant Declaration above. (Required)
Caregiver Declaration
If in doubt after completing the questionnaire, consult your doctor prior to physical activity.
Has the Caregiver had (within the past 12 months) a bone, joint, or soft tissue (muscle, ligament, or tendon) problem or other medical conditions that could be made worse by becoming more physically active?*
- Yes
- No
Has the Caregiver's doctor ever said that they should only do medically supervised physical activity?*
- Yes
- No
CAREGIVER DECLARATION*
If you are less than the legal age required for consent or require the assent of a care provider, your parent, guardian or care provider must also sign this form.
I, the undersigned, have read, understood to my full satisfaction and completed this questionnaire. I acknowledge that this physical activity clearance is valid for a maximum of 12 months from the date it is completed and becomes invalid if my condition changes. I also acknowledge that the community/fitness center may retain a copy of this form for its records. In these instances, it will maintain the confidentiality of the same, complying with applicable law.
By clicking this box, I declare that I have read the Caregiver Declaration above. (Required)
Your Full Name*
Please enter your full name to confirm your electronic signature.

Stay Informed

MOVE by GoodLife Kids Barrie Program

Participant Information

Caregiver Information

Participant Profile

Availability

MOVE Forms & Waivers

MOVE Participation Waivers

Participant Declaration

Caregiver Declaration