In this section

MS Exercise Registration

Name *

Date of Birth *

Gender *

Disability *

Ethnicity *

Address *

Telephone number *

Email address *

Do you use a walking aid? *

No - I do not use a walking aid
Yes - I use a walking aid

How did you hear about the programme? *

As a Local Authority we collect, hold and process information supplied by you in accordance with the Data Protection Act, to allow us to provide services effectively. You can find out more regarding this and our privacy notice here.

This information will be shared with our instructor.

Was this page useful? *

Yes - It was useful
No - it wasn't useful