Fall 2026 Diabetes Fit Expression of Interest Form

Diabetes Fit Fall 2026

Expression of Interest Form
Please complete this form to express your interest in joining a YMCA of Three Diabetes Fit program. This fall, we will be offering in person programs (Kitchener, Waterloo, Guelph, Stratford and Cambridge locations). Virtual option will also be available. Access to a device and internet for ZOOM video conferencing is required to participate in the virtual program.
To be eligible for Diabetes Fit, one of the following criteria must be met:

1) You have a diagnosis of Type 2 Diabetes

2) You have a diagnosis of Prediabetes

3) You are at moderate-high risk for type 2 diabetes on the CANRISK calculator. Take the test: https://www.healthycanadians.gc.ca/en/canrisk
Your Name

First NameLast Name
Email
example@example.com
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Please indicate which program you are interested in attending
Please indicate your second choice of program should your first choice be unavailable
How did you hear about Diabetes Fit

Other
Should be Empty:

Diabetes Fit Fall 2026