Adult Therapeutic Physical Fitness Application Materials

TO:       Prospective Adult Therapeutic Physical Fitness Program Participants
FROM:   Manny Felix, Ph.D., Director, Special Populations Programs

Thank you for your interest in the Adult Therapeutic Physical Fitness Program at UW-La Crosse. Below you will find links to program information and registration forms.

To enroll an individual in the program, please download and complete the following forms and return them to the Special Populations Programs, 114 Wittich Hall, UW-La Crosse, La Crosse, WI 54601 (do not send any program fees at this time):

  1. Participant Information Form
  2. Emergency and Photo Release Forms
  3. Participant Informed Consent Agreement
  4. Additionally, please download the Medical Release and Medical Information Forms.  Complete only the medical release form and forward this release and the medical information form to the participant's doctor.  The medical information form should then be completed by the doctor and sent back to the Special Populations Programs office.

If space is available for new participants, we will notify you of acceptance. If space is not available, we will place your name on a waiting list.

If you have any questions, please feel free to contact our office at 608-785-8690 between 9:30 am and 3:00 pm, Monday through Friday.

Again, thank you for your interest.

Special Populations Programs
114 Wittich Hall, UW – La Crosse, La Crosse, WI 54601
Director Phone: (608) 785-8691 Office Phone: (608) 785-8690
Fax: (608) 785-8206 Email:
specialpops@uwlax.edu