MOM&BABY FITNESS
Sign up here for the free mom & baby fitness classes!
YOUR DETAILS
*
First Name
Last Name
Gender
*
DOB
*
-
Day
-
Month
Year
Date Picker Icon
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
What would you like to achieve?
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Increase mobility
Improve coordination
Build a healthy lifestyle
Build confidence
Improve strenght
Better Mental-Health
Overall physical health
Socializing
Other
Please briefly highlight any mobility issues, learning disabilities,or health details relevant to you partaking in physical activity.
Which session would you like to come to?
*
5pm to 6pm THURSDAYS
11am to 12 MONDAYS TBC
How many babies or toddlers are coming with you? Please add their age.
Consent to pictures and video being used on the JONES&US channels?
YES
NO
Phone Number
*
-
Area Code
Phone Number
Email
example@example.com
Personal details submitted on this form are confidential.
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