Instructor Recruitment/ Starter Kit Arthritis Foundation Chapter/ Agency Name

CLASS OUTCOMES

The results of a pilot test demonstrate that, as a result of its recreational and social aspects, participants in an Arthritis Foundation Aquatic Program class can experience:

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  A reduced level of pain
  

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  An improved ability to function independently in day-to-day life
  

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  A decrease in feelings of isolation and depression
  

Contact us today to bring these benefits to individuals in YOUR community.

1. 
   Certification as an Arthritis Foundation Aquatic Program Leader/ Instructor requires:
   

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  Successful completion of an Arthritis Foundation Aquatic Program Leader/ Instructor Training Workshop.
  
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  Successful teaching of at least six one-hour Arthritis Foundation Aquatic Program classes within six months of completing an Arthritis Foundation Aquatic Program Leader/ Instructor Training Workshop and submission of participant data to the Arthritis Foundation.
  
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  Teaching at least one class series annually and submission of participant data.
  
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  Attendance at recertification training every three years.
  

2. 
   Current certification in cardiopulmonary resuscitation is required.
   

3. 
   Additional qualifications for INSTRUCTORS:
   

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  YMCA, Red Cross or other nationally recognized lifeguard or water safety/ rescue certification is required.
  
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  First aid certification is strongly recommended.
  

4. 
   Deep Water Instructors must meet the following in addition to the INSTRUCTOR qualifications:
   

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  Ability to swim at least 25 yards without stopping; ability to jump into deep water, surface, and either float for a minimum of 10 minutes or tread water for at least 1 minute.
  
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  Successful completion of an Arthritis Foundation Aquatic Program for Deep Water Instructor Training Workshop.
  

5. 
   Juvenile Arthritis Instructors must meet the following in addition to the INSTRUCTOR qualifications:
   

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  Current Infant and Child CPR certification.
  
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  Successful completion of an Arthritis Foundation Aquatic Program for Juvenile Arthritis Instructor Training Workshop.
  

6. 
   Affiliation with a facility or agency that can provide warm water aquatic classes and insurance coverage for the program.
   

7. 
   Other desirable abilities include:
   

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  Empathy towards people with arthritis and related diseases gained through personal or professional experience.
  
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  Interest in working with groups of people with arthritis and related diseases.
  
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  Experience in teaching exercise classes; skill in group process and instructional techniques.
  
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  Desire and ability to help others.
  
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  Strong belief in the value of regular physical activity.
  

1. 
   Commit to following all program policies regarding the Arthritis Foundation Aquatic Program and conduct all class sessions in accordance with the Arthritis Foundation Aquatic Program Instructor’s Guide and Guidelines and Procedures Manual, without changing the exercises or making other changes, additions or deletions. Sign a Statement of Understanding to document this commitment.
   

2. 
   Participate in pre-class planning and activities as time and ability allows to assure successful classes, including tasks such as: working with the host facility to set class meeting dates and times, to schedule the pool time, and to ensure correct water and air temperature levels; publicizing classes to recruit class participants; notifying the Arthritis Foundation of class schedules; and assisting with registering participants.
   

3. 
   Establish and enforce guidelines for participants:
   

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  Avoid discussion or promotion of specific physicians, health professionals, health institutions or unproven remedies.
  
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  Do not provide answers to specific medical questions, specific treatment advice, or individualized exercise programs.
  
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  Adhere to a “no touch” policy - no one is allowed to manipulate another’s limbs to help with exercises.
  
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  Remind participants to observe safety principles such as the “two hour pain rule,” slowing down when tired, limiting movements that are painful, and avoiding vigorous exercising of inflamed joints.
  

4. 
   Monitor the safety of participants during class:
   

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  Proper pool entry and exit
  

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  Lifeguard or person with water rescue/ safety certification on duty (consistent with state health regulations)
  
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  Exercises performed correctly and with limbs/joints immersed
  
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  Participants monitored for painful grimacing, flushed faces, and other signs of overexertion or hypo/hyperthermia
  
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  Deck uncluttered
  

5. 
   Practice emergency drills and understand and comply with the facility’s emergency policies, procedures and practices.
   

5. 
   Take attendance at every class and submit timely and accurate participant data (such as attendance list/ program report forms) and release forms from new participants on a quarterly basis or as required by the Arthritis Foundation.
   

5. 
   Participate in evaluation procedures established by the Arthritis Foundation, including but not limited to site visits, participant surveys and instructor questionnaires.
   

5. 
   Inform class participants about other Arthritis Foundation resources and activities that may interest them.
   

5. 
   Communicate problems, concerns, questions or suggestions promptly to the Arthritis Foundation.
   

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  Attendance at one-day or 1 ½ day leader/ instructor training workshop
  
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  Attendance at a ½ day deep water or juvenile instructor training workshop (as appropriate)
  
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  Attendance at recertification workshop every 3 years
  
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  Preparation time (approximately 1-2 hours)
  
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  Class time (approximately 12-16 hours per 6-8 week class series that meets twice a week)
  
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  Logistics time (approximately 2-4 hours per class series)
  

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  Arthritis Foundation Aquatic Program sites must provide a pool with:
  
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    Water temperature maintained between 83 and 88 degrees Fahrenheit
    
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    Air temperature within five degrees of the water temperature
    
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    Clean and uncluttered deck area
    
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    Readily available safety equipment
    
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    For the basic and plus classes, pool depth sufficient so that participants can sit or stand comfortably with shoulders submerged during upper extremity exercises
    
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    For the deep water class, pool depth sufficient so that class participants can float upright wearing a flotation device without touching the pool bottom
    
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    In accordance with state law, provide a written emergency procedure and an instructor or other person at the pool with current lifeguard or water safety/ rescue and CPR certification. It also is strongly recommended that there be a second person at the pool or immediately available to assist with water rescue
    

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  An accessible site consistent with the Americans with Disabilities Act, including reasonable accommodations such as:
  
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    Handicapped parking spaces or other designated parking within 200 feet of entrance
    
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    At least one building entrance with an easy-to-open door close to parking and useable by persons with disabilities. Entrances with steps should have railings
    
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    Barrier-free pool accessible to people with disabilities
    
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    Accessible changing and restroom facilities, with adequate provisions for seating, located near the pool
    
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    Entrance doors that are easily operable by people with upper extremity limitations in the locker room, locker and restroom
    

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  Ensure that the Arthritis Foundation programs are only taught by persons who have successfully met the prerequisites, completed an approved Arthritis Foundation Aquatic Program instructor/leader training workshop and are up-to-date on their Arthritis Foundation certification
  
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  Provide adequate liability insurance coverage (at least $1 million)
  
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  Secure signed release form from all class participants relinquishing the Arthritis Foundation and the facility of financial responsibility or liability incurred as a result of program participation
  
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  Ensure that the full Arthritis Foundation Aquatic Program name is used in all written materials
  
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  Provide program statistics and other requested evaluation data
  
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  Allow classes to be open to the community unless specific arrangements have been made with the AF
  
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  Sign a program co-sponsorship agreement to document mutual responsibilities
  

Instructor Training Workshop Application Form

FOR OFFICE USE
Date of Training: ____________Location:_________________________________________________



COMPLETE ALL SECTIONS. TYPE OR PRINT NEATLY.

Today’s Date: _________________________

This application is for:  Initial Training  Recertification

CONTACT INFORMATION

First Name:	MI:		Last Name:
Job Title:
Organization:
Work Address:
City:				State:		Zip:
Home Address:
City:				State:		Zip:
Home Phone:		Work Phone:			Cell Phone:
Email:
For Arthritis Foundation correspondence, please contact me at:  My worksite (if applicable)  My home

FACILITY INFORMATION
Please provide information about the host facility where you plan to teach the Arthritis Foundation Aquatic Program classes (if different from your job location):

Facility Name:
Address:
City:	State:	Zip:
Administrator/ Contact Person Name:
Phone number	Email address:

Does the location where you plan to teach have a signed Program Co-sponsorship Agreement with the AF?  YES  NO

QUALIFICATIONS *Attach copy of card

Do you have a current lifeguard or water safety/rescue certification? (Required for AF Aquatic Program Instructors)	 YES*  NO
Do you have current ADULT CPR certification? (Required)	 YES*  NO
Do you have current Child CPR certification? (Required for AF Aquatic Program for JA)	 YES*  NO
Do you have current First Aid certification (Recommended)	 YES*  NO
Can you swim at least 25 yards without stopping, jump into deep water and float for 10 minutes or tread water for 1 minute? (Required if you do not have lifeguard or water safety certification and want to teach the AF Aquatic Program for Deep Water or JA)	 YES  NO
List other relevant certifications and their expiration date:

EXPERIENCE

What professional or volunteer experience have you had leading aquatic or exercise classes, conducting workshops or speaking in public?

What is your profession and/or background in health, fitness or education? List any relevant degrees or course work.

What other experience do you have that you feel would be beneficial in leading the Arthritis Foundation Aquatic Program (such as work with people with disabilities, older adults, people with special needs)?

What is your experience with arthritis (personal or family member diagnosis, or work with people with arthritis)?

Why do you want to teach the Arthritis Foundation Aquatic Program? What benefits would you like to gain?

How did you become aware of the Arthritis Foundation Aquatic Program?

Have you been a participant in any Arthritis Foundation programs and if so, what?

FEE INFORMATION

I agree to pay (check one) :  $XX for Initial Training  $XX for Recertification Enclosed is a check  or please charge my:  AMEX  VISA  MC Card #: ______________________________________ Expires: ­­­­­­­­­­­­­______________________________________ Name on Card: ­­­­­­­­­­­­­________________________________ Signature: ­­­­­­­­­­­­­____________________________________ Please make checks payable to:

Please send complete application, payment and attached SIGNED Statement of Understanding to:

Leader/ Instructor Statement of Understanding
The Arthritis Foundation has established the following policies and procedures to ensure the quality of its programs. Please sign on the following page to indicate your acknowledgement and acceptance of these requirements:

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  As the first step in becoming an AF certified Leader or Instructor, I will attend and successfully complete an AF Leader/ Instructor Training Workshop conducted by trainers who are nationally certified and authorized by the Arthritis Foundation. I will actively participate in all aspects of the training. I understand that only approved trainers can teach others to become AF Leaders or Instructors. I may not teach others how to lead the AF program classes.
  

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  In order to attend an AF Leader/ Instructor Training Workshop, I will pre-register by submitting a completed Application Form and this signed Statement of Understanding. I will be pre-screened by the AF to ensure that I have the appropriate prerequisite qualifications. I will receive written confirmation of my attendance at the workshop. I understand that walk-ins are not allowed at AF Leader/ Instructor Training Workshops.
  

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  As the second step in becoming an AF certified Leader or Instructor, I will conduct an Arthritis Foundation Self-Help Program course series of at least 6 weeks duration or at least six one-hour classes of the Arthritis Foundation Aquatic Program, Arthritis Foundation Exercise Program or Arthritis Foundation Tai Chi Program within six months of completing the AF Leader/ Instructor Training Workshop.
  

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  As a condition of maintaining my certification, I will further conduct a minimum of one Arthritis Foundation Self-Help course series or six Arthritis Foundation Aquatic or Arthritis Foundation Exercise or Arthritis Foundation Tai Chi class sessions each year. I will send the attendance lists from these classes to the AF. I will also attend an AF Recertification Workshop every three years and agree to participate in annual continuing education activities when available from the AF.
  

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  I understand that certification as an AF Leader or Instructor provides me with a limited license to deliver the AF program in which I’ve been trained as long as I maintain my affiliation with the Arthritis Foundation and uphold its policies and procedures. I acknowledge that the AF program materials are copyrighted and agree to honor the programs’ copyright protection.
  

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  I will offer AF classes only at sites that have a complete and current Program Co-sponsorship Agreement on file with the AF documenting their compliance with AF policies and their acceptability as host sites, including adequate insurance coverage and accessibility to people with disabilities. I agree to notify the AF if I stop teaching the AF program at the approved site or if my teaching status changes.
  

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  I will conduct and support marketing efforts for the AF classes in my community in collaboration with the AF. I will notify the AF well in advance of each course series to assure adequate time for promotion and other preparations.
  

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  I will stress my collaboration with the AF in all marketing materials and during every AF course series. I will assure that participants recognize the AF’s co-sponsorship of the programs. I will provide participants with information about other AF programs and services.
  

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  I agree to follow the standardized program curriculum and will not make any variations in the approved program content or process described in the program leader/instructor manuals without prior written permission.
  

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  To protect the AF and the host facility against legal claims, I will secure Participant Release Forms from all new course participants and will submit these forms to the AF. I will also communicate and enforce the safety principles I learn in the AF Leader/ Instructor Training Workshop.
  

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  I will submit complete and timely participant data and participate in any other data collection projects that the Arthritis Foundation uses to measure the reach, quality and/or impact of the AF programs in accordance with a specified reporting schedule and method.
  

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  I agree to uphold and maintain the policies, procedures and standards of the AF program and to fulfill all obligations listed in the AF Leader/ Instructor Position Description and in the AF Leader/ Instructor manuals and guidelines and procedures manuals.
  

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  I understand that the Arthritis Foundation is a voluntary health organization. If serving in a voluntary capacity, I will not receive compensation or employee benefits from the Arthritis Foundation. However, an honorarium may be paid.
  

This agreement applies to:

 Arthritis Foundation Aquatic Program  Arthritis Foundation Aquatic Program for Deep Water

 Arthritis Foundation Aquatic Program for JA  Arthritis Foundation Exercise Program

 Arthritis Foundation Self-Help Program  Arthritis Foundation Tai Chi Program

I HAVE READ AND I UNDERSTAND THE PRECEDING STATEMENTS. I FURTHER UNDERSTAND THAT COMPLIANCE WITH THIS STATEMENT OF UNDERSTANDING IS REQUIRED FOR MY TRAINING AND CONTINUED PARTICIPATION AS AN ARTHRITIS FOUNDATION LEADER OR INSTRUCTOR.

________________________________________ _______________

Print Name of Leader/Instructor Applicant Date
__________________________________ Signature

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