Staying Fit for the Future Waiting List
Staying Fit for the Future is an 10-week physical activity programme to improve strength and balance as well as your general aerobic fitness. If you wish to be added to the waiting list for your preferred location please complete the form below. If you have any questions on the waiting list please email wellcommactive@corksports.ie or call 086-1276863 / 086-1409225
Participant Name
*
First Name
Last Name
Email
example@example.com
Phone Number
*
Please enter a valid phone number.
Are you completing this waiting list on behalf of yourself?
*
Yes
No
If you answered No to the above question. What is your relationship to the person that you are completing the form for and are the contact details the participants or yours?
Which venue are you interested in joining?
Other
If there is a location in which you would like to see the programme run please put in here. If we have enough participants we will explore the possibility of running the programme in your area.
Submit
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