Walk Talk & Tone Programme

1
Walk, Talk & Tone Programme

Objective: A social exercise class to get adults moving with low impact exercise along the route.

Venue: Portadown Peoples Park

Dates: Wednesday 18 November | 25 November | 2 December | 9 December

Time: 10am

Cost: £10 (4 week block)
2
Participants Name* This field is required.
First Name
Last Name
3
Phone Number* This field is required.
4
Email* This field is required.
example@example.com
5
Are there any personal/medical requirements that we need to be aware of?* This field is required.
YESNO
6
Please detail any personal / medical requirements.* This field is required.
Huge
Large
Normal
Small
Ok
Ok
7
Emergency Contact Name* This field is required.
First Name
Last Name
8
Emergency Contact Number* This field is required.
9
I confirm I am over the age of 18 years old* This field is required.
Yes
10
We may take and use photo/videos recordings for reporting/advertising. Do you agree to be photographed or recorded?* This field is required.
YESNO
11
I consent to my data be used as per terms of the Privacy Policy* This field is required.
I consent
12
I have read and consent to the Terms & Conditions* This field is required.
I consent
13
We'd love to stay in touch with you, we'll always treat your information carefully as described in our privacy policy Would you like to hear about events and courses from our Health & Recreation Department?* This field is required.
I'd Love to hear from youNo thanks
14
Payment
prevnext( X )
Should be Empty: