REGISTRATION - shop4wellness.uk

First Name *

Email Address *

Mobile Number

Privacy

Your personal data will not be shared or disclosed to third parties. It will be used solely for the purposes of the S4LW Programme. For full details please see our Privacy Policy.

PAR-Q Screening: Do you currently have, or have you ever had, any health condition we should know about before you exercise?YesNo

Condition SelectorHeart condition or high blood pressure (doctor diagnosed)Chest pain at rest / during activityDizziness / Fainting spells (balance / loss of consciousness in the last 12 months)Surgery / Injury in the last 12 monthsCurrent prescribed medication for a chronic conditionBone / joint problems (Arthritis, Osteoporosis, Back/Knee issues)Other diagnosed chronic condition (e.g. diabetes, COPD)Doctor has advised medically-supervised exercise onlyOther

Is there anything else about your health you’d like to tell us?

ImportantIf you answered YES to any question above, please consult your doctor before becoming more physically active. Tell your doctor which questions you answered YES to.

Join Pay and Play Swimming *Pay and Play Swimming

Note:

Note: All activities such as Zumba, Chair Pilates, Diabetes Seminars, Women-Only Swimming, and Adult Swimming Lessons will appear in the form, but they are scheduled for later dates. Registration will open once they become available.
At this moment, you can only register for the Pay and Play Swimming activity.

Register for Activities

Register for
Activities