Slow Runners Club!
We are so excited to launch this club as part of our Capable Communities Project! We believe that you dont have to be fast to be able to run, and that running is a skill that can be taught. We will be using these sessions to impart skills and get you going, to build your confidence in running and movement.
Name
*
First Name
Last Name
DOB
*
-
Month
-
Day
Year
Please note, if child under 16 is joining, a responsible adult must join and attend at the same time
Email
*
example@example.com
Which clinic do you attend?
*
Please Select
Drovers
Anchorage Drive
Kings Park
Mobile Service
None
Which services have you used with us in the past?
*
Physiotherapy
Exercise Physiology
Massage Therapy
Pilates - Physio Classes
Pilates - Reformer Classes
Exercise Class
Return to Performance Programming
Hydrotherapy
Other
Please tell us about your running experience?
*
Do you have any current or past injuries or medical conditions?
*
I understand that participating in Slow Runners Club will carry a small amount of risk, as with any exercise program. I will not hold Leaping Giraffes Pty Ltd and associated employees, contractors, volunteers and directors accountable for any injury that may occur as a result of participating in The Slow Runners Club.
*
Yes
I agree to the use of an Electronic Signature in the completion of this document
*
Please Select
Yes
Signature (please type your name)
*
Submit
Should be Empty: