New Direction

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* 1. Name

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* 2. Age

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* 3. Gender

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* 4. Do you live in the Borough of Havant?

Yes

No

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* 5. 5. In the last 7 days, have you taken part in less than 30 minutes moderate intensity exercise (been slightly out of breath/red in the face)?

Yes

No

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* 6. Email address