Over 60's Exercise class
Please fill out his application form if you wish to take part in our classes
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Full Name *
Phone Number *
Email address
What area of Birmingham do you live in? *
Age *
Gender *
Emergency Contact Name and Number *
Do you have any conditions that we need to be aware of? 
PLEASE READ CAREFULLY: I am aware that by my participation in classes or activities provided by ashebo CIC, I agree to take full responsibility for not exceeding my limits in the practice of online exercises sessions.  It is my responsibility to ascertain that there is no medical reason to prevent my participation. I waive any claim that I might have at any time for injury of any sort against ashebo CIC. I have carefully read understand and agree to the above. *
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