KEEP FIT DURING

YOUR PREGNANCY!

Benefits of Prenatal Exercise

Research has shown that exercise provides many benefits to pregnant women and their developing fetus. Some of these benefits include:

*Reduced weight gain during pregnancy and more rapid weight loss after pregnancy

*Improved mood and sleep patterns

*Decreased risk of urinary incontinence due to pelvic floor dysfunction and weakness

*Relief or prevention of back pain

*Increased rate of postpartum recovery

*Increased understanding of how posture is affected by pregnancy

*Support system for expectant mothers

OPELIKA SPORTSPLEX1001 Andrews Rd.

Opelika, AL 36801P.O. Box 1026

Opelika, AL 36803

Phone: 334-705-5560

Fax: 334-705-5568

E-mail: LGallagher@opelika.net

Bump It Up!Prenatal Fitness

Class DetailsMeeting Days: Mondays, Wednesdays and Fridays

Time: 5:30-6:30 p.m.

Opelika Sportsplex & Aquatics Center1001 Andrews RoadOpelika, AL 36801

(334) 705-5560www.opelikasportsplex.comContact: Lisa Gallager

In addition to helping you stay in shape during pregnancy, our fitness classes can connect you with other expectant moms, creating a sense

of community. According to the American College of Obstetricians

and Gynecologists (ACOG), exercise during pregnancy, in the absence of

either medical or obstetric complications, is encouraged.

Bump It Up!Prenatal Fitness

Consent Form for Prenatal Fitness Classes

PARTICIPANT SECTION

I request enrollment in the Bump It Up! Prenatal Fitness class sponsored by the Opelika SportsPlex. I certify that I have given my treating physician the written information about this class, have discussed its risks and benefits with this physician, and have obtained the approval of my treating physician to participate. I agree to keep my physician informed of the effects of this class on my body and to obtain approval to continue participation on a monthly basis. I understand that without writ-ten permission of my treating physician, I will not be allowed to enroll or continue in this class. I also understand that there is no requirement to perform all the class exercises and that I can withdraw from this class at any time (refund policies apply).

During class, I agree to limit my activity to that level which is comfortable for me and to stop all activity if I feel uncomfortable. I will notify the class instructor and my physician if the class activity causes any discomfort. I understand that all forms of exercise involve some risk of injury.

____________________________________________________Signature of Participant Date

____________________________________________________Participant Name (please print)

TREATING PHYSICIAN SECTION

I have reviewed the information on the maternity fitness class entitled Bump It Up! Prenatal Fitness. I have discussed the benefits and risks of such participation with my patient, _________________, and have assessed her ability to safely perform the exercises involved. I approve of my patient’s par-ticipation in this class and will reassess this approval for each month that she wishes to participate.

Gestational week as of this date: ___________________

List any exercises or precautions that this patient should not per-form: _______________________________________________

____________________________________________________Signature of Treating Physician Date

____________________________________________________Print Name Office Telephone

This completed form must accompany your registration.