Community Course Registration

Community Course Registration

Please fill your details below to enrol in your chosen course.
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Men's Fitness and Wellness

Normally $210 - Special price in term 4!

$170.00 AUD

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Student Name

First NameLast Name
Mobile Number
Please enter a valid phone number.Format: 0000 000 000.
E-mail
example@example.com
Gender
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Suburb of Residence

Street Address

Street Address Line 2

SuburbState

Postal / Zip Code
Year of Birth
Please type your year of birth
Country of Birth
Emergency Contact Name
Emergency Contact Mobile
Please enter a valid phone number.Format: 0000 000 000.
The following questions help our trainer understand your health needs and tailor activities appropriately. Having a health condition does not necessarily prevent you from participating in the program.
1. Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?
2. Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?
3. Do you ever feel faint, dizzy or lose balance during physical activity/exercise?
4. Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
5. If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose) in the last 3 months?
6. Do you have any other conditions that may require special consideration for you to exercise?
7. How would you describe your current level of exercise
Would you like to stay in the loop?
Should be Empty: