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LPR Walk With Ease Programs Request Form

  1. Liberty Parks & Rec is launching virtual evidence-based programs to improve the health of the community. These groups will be be developed based on demand and are FREE to all. Please submit request to join all groups you would be interested in.
  2. By submitting your email you are opting in to receive emails from Liberty Parks & Rec about these programs.

  3. Walk With Ease*
    Walk with Ease is a fitness program shown to relieve pain and improve health. This evidence- based program was developed by experts at the Arthritis Foundation and helps participants build up and maintain a successful walking routine. If participants can be on their feet for 10 minutes without increased pain they can have success with this program. This program is twice per week for 6 weeks. Virtual option offers education and stretching in a closed group virtual classroom and walking independently.

    Select all that apply:
  4. What is your preferred time for programs?*
    Select all that apply:
  5. How important is physical activity in your life?*
  6. Please site your current percieved stress level from 0-10, with 0 being low stress and 10 being high stress
  7. Participation Waiver
    I am over the age of 18 and acknowledge I have been informed of the need for a physician’s approval for my participation in wellness programming. I acknowledge I have either had a physical examination and been given my physician’s permission to participate, or if I have chosen not to obtain a physician’s permission prior to beginning this program, I acknowledge I am doing so at my own risk.

    I understand and am aware that health and wellness programming includes potentially risky activities. I am voluntarily participating in these activities with knowledge of the potential risks. I hereby agree to hold harmless Liberty Parks & Recreation, its respective representatives, executors, agents, and assigns from any and all claims, demands, damages, rights of action or causes of action, present or future, arising out of or connected to my participation in any and all wellness programming.

    I acknowledge I have thoroughly read this waiver and release and fully understand it is a waiver and release of liability. By signing this document, I am waiving any right I, or my heirs and/or assigns, may have to bring any and all legal actions or assert any and all claims against Liberty Parks & Recreation, its respective representatives, executors, and/or assigns.

    * I have read the above information and fully understand its contents. I voluntarily agree to the terms and conditions stated above.
  8. Acknowledgement*
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