Free Taster Registration

Full name

Email address (optional)

Telephone number

Emergency contact name and number

Has a healthcare professional advised you not to exercise, or to exercise only under supervision?

Yes

Do you experience chest pain, have a heart or circulation condition, or unusual breathlessness?

Yes

Do you experience dizziness, fainting, falls or difficulties with balance?

Yes

Do you have an injury, recent operation, health condition, medication or mobility concern that could affect your participation?

Yes

If you answered Yes to anything above, please briefly explain. You can also tell me whether you use a walking aid or would like a chair available.

I confirm that the information provided is accurate and explicitly consent to Harmony Health & Beyond using this health information to understand my health, support my safety and make suitable class adaptations. I have read the Privacy Policy.

Free Taster Registration & Health Screening

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