Personal Information

    Full Name (First name & Surname)

    Gender

    Age

    Email

    Phone Number

    Post Code

    Emergency contact no. & Relationship to you

    How did you hear about this service/class?

    Health Information

    How do you feel at present?

    Rate your health as per the option

    Physical fitness

    Wellbeing & Mental health

    Disability (Please tick what’s applicable)

    Ethnicity Information

    White

    Asian or British Asian

    Black or British Black

    Mixed

    Chinese or other group

    Prefer not to say

    Terms and Conditions

    While the instructor/tutor will make every effort to ensure the exercises/activities are safe and suitable, it is the responsibility of each participant (or the parent/guardian for those under 16) to be aware of their own limitations and act accordingly. Participants should notify the instructor if in doubt and modify or stop any activity as needed. If unsure, please consult a GP before participating. By signing you confirm that you are in good health or have consulted with your GP if necessary to participate in the activities and you release Apna Virsa and its staff from any liability for injuries or damages related to your participation.

    Please Note that we sometimes take pictures or videos of the workshops/activities for our funders and social media so that these can be shared. Please advise the cameramen or the photographers if you are not happy to be in pictures or videos.

    Social Media: Apna Virsa sets-up and utilises social media /WhatsApp groups to keep its learners informed of activities or notifications about classes. It is prohibited for learners to utilise these groups for any other purposes without the express permission of an Apna Virsa team member.

    GDPR: All and any information or data that you provide will not be shared with any third party without your prior permission. You are able to check the data the we “hold” and or we have it deleted at any reasonable time. Only depersonalised data is used for analysis in order to review progress, provide supporting evidence to funders if applicable, Improve existing services and plan new services.

    Code of Conduct: Code of conduct document will be provided before registration and you are required to read, understand and sign the registration form and abide by all those when you are in the activities or sessions. Click Here To View Document