Please note once we have received your supporting information we will be in touch to confirm your place if you meet our eligibility criteria. If your  supporting information  does not meet our eligibility criteria, we will be in contact with alternative membership options. All applications submitted between 15th December 2021 and 4th January 2022 will be reviewed in January. 

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* 1. Your contact details

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* 2. What is your current weight (kgs)

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* 3. What is your current height (cms)

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* 4. Date of Birth

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* 5. Would you like to attend?

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* 6. How did you join the group?

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* 7. How would you describe your gender?

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* 8. How would you describe your ethnicity?

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* 9. Please state your religious denomination

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* 10. What is your employment status?

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* 11. How would you describe your sexual orientation?

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* 12. Are you currently pregnant?

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* 13. Do you have any disabilities?

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* 14. Are you listed on the Severe Mental Illness register?

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* 15. Are you listed on the learning disability register?

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* 16. Do you have any of these conditions?

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* 17. Trilogy Leisure Physical Activity Readiness Questionnaire 

Regular physical activity is fun and healthy, and increasingly more people are starting to become more active every day. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming much more physically active. Completion of this questionnaire is a first step when planning to increase the amount of physical activity in your life.

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Has a Doctor / Medical Professional ever diagnosed you with a heart condition and indicated you should restrict your physical activity?
When you perform physical activity, do you feel pain in your chest?
When you were not engaging in physical activity, have you experienced chest pain in the past month?
Do you ever faint or get dizzy and lose your balance?
Do you have an injury or orthopaedic condition (such as a back, hip, or knee problem) that may worsen due to a change in your physical activity?
Do you have high blood pressure or a heart condition in which a Doctor / Medical Professional is currently prescribing a medication?
Are you 69 years of age or older and not used to being very active?
Do you know of any other reason you should not exercise or increase your physical activity?
I have read, understood and completed the above questionnaire and acknowledge that there are risks and dangers inherent in physical exercise and duly undertake the activity at my own risk. Any liability on the part of the operators is excluded unless negligence can be proven. I agree to observe the rules and conditions of membership. I also acknowledge that I must not use any piece of equipment for which I have not been shown how to use by an instructor. I confirm that the information that I have provided is correct at this time and should I become aware of any relevant changes to my health or condition, I will inform an instructor.
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