Consent Form Chair Based Exercise June - November 2026

1. Consent Form Chair Based Exercise June/July 2026

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Name

First:

Last:

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Contact number

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Emergency Contact Name & Number

Name:

Number:

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Emergency Contact number

Email address

Medical information: (any medical condition we need to be aware of e.g. illness, allergies, mobility etc):

Other information (anything you think we need to know):

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Attendee is over 18 years old.

Yes

No

Progress

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