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* 1. What is your full name? Please enter the second persons details if applicable

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* 2. What is your full GROUPON Voucher Code/ Number & Security/ redemption code please? (Please enter all details and we will need the voucher sending in once contacted) 

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* 3. At what email address would you like to be contacted? Please add the second persons email address if applicable

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* 4. What is the park/ venue of choice for your first session?

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* 5. Preferred starting date? (Month / Date / Year) 

Date
Date
Date
Date
Date
Date
Date

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* 6. If you use social media and want us to follow you, become a friend or link up please let us know your usernames and details?

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* 7. What is the best number to contact you on?

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* 8. What is your fitness level out of 10 - 1 been the least and 10 been optimum fitness level

 
Fitness Level 1-10

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* 9. Do you have any other comments, questions, or concerns?

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* 10. Are you ready to change your life, give it a go, meet new people, have fun and start your health regime?

T