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Senior Sneakers Registration
October 27th 4pm-5pm
Please fill out this form to register for the hour-long Senior Sneakers class in North Conference Room 1 & 2 at Cheshire Medical Center. There will be directions to get to the room when you arrive at the main entrance.
*
1.
Personal Information
(Required.)
First name of participant
Last name of participant
Email
Zipcode
*
2.
How did you hear about this event?
(Required.)
Monadnock Shopper News
Facebook
Email
Cheshire Medical Center Community Education Webpage
Healthier Together Newsletter
Other (please specify)
3.
Would you like to receive our monthly e-newsletter, Healthier Together?
Yes
No
