Eat, Move, Be Happy Enrolment
If you are interested in enrolling in any of our programmes, just fill out the form below to sign up.
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Email *
First name *
Last name *
Post code *
Contact number *
Emergency contact name *
Who should we contact in case of emergency?
Emergency contact details *
The email or phone number of your emergency contact.
Date of birth *
Which service are you interested in? *
For full descriptions of all the services on offer, go to
Have you been referred by an Airedale, Wharfedale or Craven health professional? *
Referring organisation
Please name the surgery/organisation that referred you below.  If you are self funding, please leave blank.
Medical conditions or disabilities *
Please tick if you have any of the following:
Which GP practice are you registered with?
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