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Tri Pounamu - Event Request Survey 

Event Survey

Thank you for completing this short survey. Upon return of this survey, we will be in contact to deliver your event support. 
The data collected allows us to provide information to third parties to register you for events.  Some identifying information will be passed on to third parties including for the purposes of entering you into events. 
1.What is your full name? (as you would like it to be on entries)
2.Date of Birth(Required.)
3.What are your email and mobile contact details to arrange delivery of your event support?(Required.)
4.What event are you requesting support for?
5.Do you have a medical condition that would affect your ability to exercise?
6.Consent to register for an event
7.Have you done an exercise event before?
8.Can you currently do any of the following? Answer as many as applicable
9.How many days a week do you currently exercise for 30 minutes or more?
10.What is your current health and wellness goal for 2017?
11.Are you interested in doing any other events in 2017?
12.Do you have any further comments or questions?