FitChicks - Expressions of interest form

Looking for a way to ease back into some physical activity along with a group of mums and mums-to-be like you? Capital Chicks CANberra are being invited by Touch Football ACT to take part in free FitChicks sessions – and you can bring the kids! The sessions, based around some team sport principles, are designed to be fun, simple and ease you back into physical activity for better overall health outcomes.

Start date: Tuesday 27th October
Runs for: 6 weeks
Session time: 10.00-10.45am, with coffee
afterwards
Location: Makin Place, Deakin

Cost: Free!

Kids welcome and entertained with games by Uni of Canberra students!

Come & Try 13th October 10-10.45, Deakin ovals, Makin Place

If you are interested in being a part of the FitChicks program, fill out your details below!

Question Title

* 1. Please fill out your details below before starting the survey.

Full Name

Date of Birth

Email Address

Phone Number

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* 2. If you are bringing your child to the sessions, please fill out your child's details below.

Full Name

Date of Birth

Age

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* 3. Next of kin/emergency contacts details.

Full Name

Phone Number

Relation

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* 4. Select your fitness level

Beginner

Intermediate

Advanced

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* 5. Do you have any health conditions that we need to be aware of?

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* 6. I hereby consent to Touch Football ACT staff to use any images or videos taken of me or my child for promotional purposes on social media:

Yes