Transcript Manchester Sport & Leisure Trust Brand Presentation

Women Only Session
Part of Manchester Sports Academy
Name ______________________________________________________________
Address ___________________________________________________________________
___________________________________________________________________________
Post code __________________________Date of Birth ___________________________
Gender
□ Male
□ Female
Contact Number Home ________________ Mobile ____________________________
Email Address
____________________________________________________________
Ethnic origin
□ Bangladeshi
□ Black other
□ Mixed Ethnicity
□ Pakistani
□ Black African
□ Chinese
□ Other Asian
□ White
□ Black Caribbean
□ Indian
□ Other
Ladies only Yoga and Gym sessions with a qualified instructor will be held every Monday
between 12pm - 2pm from 18th January 2010 at Belle Vue Leisure
(Address: Kirkmanshulme Lane, Longsight M12 4TF. Tel: 0161 953 2470 or visit
www.manchestersportandleisure.org)
There will be a charge of £2.10 for the 2 hour session.
A one off gym induction fee of £5 also applies. Group inductions have been scheduled
for Monday 4th and 11th January between 12pm – 2pm. Other times available on request
Which other sports would you like to take part in, if organised exclusively for ladies?
□ Badminton
□ Cricket
□ Football
□ Tennis
□ Hockey
□ Jujitsu
□ Table Tennis
□ Squash
□ Pool / Snooker
□ Other (please list) ________________________________________________________
Is there any thing that you feel is important that we need to know about?
e.g. health, disability, medications, transport, etc.
__________________________________________________________________________
Signature ___________________________________________ Date _____________________
Data Protection
We may use your information and data that you have provided above to help with any
administration, set up and running of this course, if you feel that we should not use your
information for this purpose please inform one pf the organisers, full details of all of our
terms and conditions can be obtained in writing to Manchester Sports Academy, details
below, by signing below you are agreeing with all our terms and conditions.
Manchester Sports Academy Address XXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXXX