S.W.O.T Fitness Registration Form

FREESPORTS

Pre-registration Form
This is a pre-registration form for the Mayors Free Sport programme.

Potential participants are asked to fill this out so we can allocate places acordingly.

Classes will commence on Wednesday 17th August 2016

Then every Wednesday for 8 consecutive weeks

Under 12's (4pm-5pm ) Teenage girls (5.30pm-6.30pm) Women (7pm-8pm)
Date *

Day Month Year
Phone Number *

Area Code Phone Number
Participants Name *

First Name Last Name
Age *
What is your gender?
Parent or Guardians Name *

First Name Last Name
E-mail *
What class are you interested in? *
What category do you fit in? *
What is your fitness level? *
What are your barriers to getting fit? For example child care issues. *
What would you like to achieve completing these sessions? *
Do you have any medical issues that we need to be made aware of? *

NO YES
If YES, please specify
Do you have any further questions?please specify
COMPULSORY!

This is a FREE 8 session Dance/fitness challenge.

**Participants MUST attend 6 classes

**Anyone under the age of 18 must have a consent form signed by a parent or guardian.

**Please consult your doctor if you have any injuries, as we do not want to be held liable for further injuries.
Thank you for completing this pre-registration form.

Successful applicants will be notfied shortly.
Should be Empty:

FREESPORTS