Forms

To sign up for the free 10-week Get Fit Hawaiʻi program, please complete the registration form and waiver/consent agreement and bring with you to the registration, healthy screening site.

REGISTRATION FORM & WAIVER/CONSENT AGREEMENT
Download the registration form here. Complete the form, print out a copy and bring with you to the health screening/sign-up process.

 

 

HEALTH SCREENING RECORD
This form is to be completed by a professional health care practitioner. It includes results from blood pressure test and the Stress Resilience Questionnaire.

TEAM LEADERS
To be a Team Leader, complete the following form and return via email to info@fivemountains.org or fax to 885-9013, between August 15 – 22.

Team Leader Information Form (.doc)
Team Leader Information Form (.pdf form)

VOLUNTEERS
IF you are passionate about health and would like to offer your time to support our program, we have many ways you can help. Professional Healthcare Providers are invited to become resources for participants. All volunteers, including team leaders, are asked to complete and submit (via email or fax as noted above) the volunteer agreement form.

Volunteer Agreement Form (.doc)  Volunteer Agreement Form (.pdf form)

OTHER FORMS

Can Do Goal Planner (.doc)  Can Do Goal Planner (.pdf)

Stress Resilience Questionnaire  – Self Assessment to be included in health screening record and taken at beginning and end of program

Measurement Form – Generic – a form to help with body measurement