Click here for your FREE trial class! × Please fill in this form to register for your FREE trial class! Don't forget to choose the location and date of the class you wish to attend. Join within 48 hours of your FREE trial bootcamp and receive a TLA welcome pack! Title * -- Select -- Mr Mrs Ms Dr Full name * Address * Postcode * Telephone * E-mail address * Date of Birth (dd/mm/yyyy) * Has your doctor ever said you have heart trouble? * -- Select -- Yes No Have you ever had pains in your chest? * -- Select -- Yes No Do you often feel faint or have spells of dizziness? * -- Select -- Yes No Has your doctor said your blood pressure is too high? * -- Select -- Yes No Bone or joint problems? * -- Select -- Yes No Have you been in hospital in the last 3 years? * -- Select -- Yes No Are you currently taking any medication? * -- Select -- Yes No If yes, what is it? 250 characters left Are you pre/post natal? * -- Select -- Yes No Do you suffer from asthma or breathing difficulties? -- Select -- Yes No Do you suffer from diabetes or epilepsy? * -- Select -- Yes No Do you suffer from an allergy? * -- Select -- Yes No Any other reason not to follow an activity programme? * -- Select -- Yes No How would you describe your level of fitness? * -- Select -- Very Fit Fit Average Unfit Not it at all Which location will you be coming to? * -- Select -- Boars Hill, the old golf course: 9:00 am, Sundays Sunningwell Village Hall: 7:15pm, Wednesdays Hinksey Park: 7.00pm Tuesdays Hinksey Park: 6.15am Thursdays Cumnor Village: 9:00am Saturdays On which date? * Where did you hear about us? -- Select -- Search engine From a friend Posters or flyers Magazine/newspaper On a vehicle Any other comments? 1000 characters left Please provide a digital signature * Send a copy to yourself Send