Exercise Class Declaration of Interest Form -

On what day(s) are you be available to attend (choose all that are relevant)

At what time of the day are you available (choose all that are relevant)

If your availability varies depending on the day – fill in the section below

Is there anything else you would like us to know about your availability?

What is your primary reason for your interest in the class

If you chose other, please explain:

Name *

First

Last

Email *

If you have no email, put in 000@000.com and be sure to give your phone number below

Phone Number