* 1. Date of Birth

Date of birth

* 3. Address

* 4. In the past week, how many days have you done 30 mins or more of physical activity (enough to raise your breathing rate) - Includes sport, exercise and brisk walking / cycling but NOT housework or anything you do as part of your job

* 5. Do you currently take part in any of our ALBRF activity sessions?

* 6. Following on from question 5:

* 7. What days of the week would you prefer sessions (Please choose your top 3)

* 8. What time period would you prefer sessions to run? (Please choose your top 2)

* 10. Where would you prefer to do sessions? (Please tick all that apply)

* 11. What sports / actitivites would you like to do? (Please tick all that apply)

* 12. Would you be interested in any of the following:

* 13. Please enter your email address here if you would like contacting in the future about project sessions, events and latest news

Thank you for your time!
This info will help us make the project even better!!

T