Get fit for Woking and Sam Beare Hospices!

Postponed until later in the year

Saturday 22 July 2017

MGI Midgley Snelling LLP and Achieve Lifestyle are coming together to help you get fit for summer and to raise funds for Woking and Sam Beare Hospices – the chosen charity of MGI Midgley Snelling LLP.

This is a great opportunity to feel good while doing good for Woking and Sam Beare Hospices!

With a range of events taking place throughout the morning and into the afternoon, what better way to get fit for summer?

Venue: Achieve Lifestyle, Egham Leisure Centre, (grass field weather permitting) Vicarage Road, Egham, TW20 8NL

Programme:

09.30 am – 10.00 am:
10.15 am – 10.45 am:
11.00 am – 11.30 am:
11.45 am – 12.15 pm:
12.30 pm – 01.00 pm:
01.15 pm – 01.45 pm:
Body Attack with Ross
Simply Abs with Jo-Anne
Zumba with Mark
PiYo with Samia
LBT with Olivia
Pilates with Justine

We suggest a donation of £5 for two sessions and £10 for an unlimited all-day pass. Places may be limited in the event of inclement weather, so book your place today.
Please bring your cash donation on the day.

Please bring your own mat or towel for any floor work.
Children are welcome but must be over the age of 12 and accompanied by an adult.
Sound system provided by JJ Entertainment – 07946 758216
Truck platform stage provided by NDC Services Ltd – 01932 840057
Sam Beare Hospice Register Charity Number: 1115439

To book your place, please complete the form below.

Name:

Address:

Telephone:

Email address:

Class
Instructor
Time
Body Attack
Ross
09:30
Simply Abs
Jo-Anne
10:15
Zumba
Mark
11:00
PiYo
Samia
11:45
LBT
Olivia
12:30
Pilates
Justine
13:15

How did you hear about this event?

Gift Aid
I would like Woking & Sam Beare Hospices to reclaim tax on my donation and any donations I make in the future or have
made in the past 4 years. I am a UK taxpayer and understand that if I pay less Income Tax and/or Capital Gains Tax than the
amount of Gift Aid claimed on all my donations in that tax year it is my responsibility to pay any difference. I understand
the charity will reclaim 25p of tax on every £1 that I give.
Yes, please claim Giftaid

Medical Questionnaire

1. Has your doctor ever said that you have a heart condition or high or low blood pressure? (please state below any medication you are taking)
YesNo

2. Do you suffer from any chest pains at rest or on exertion?
YesNo

3. Are you pregnant or have you given birth in the last 6 months?
YesNo

4. Are you recovering from any illness/virus or operation? (Please state below any medication you are taking)
YesNo

5. Have you had or do you suffer from:
Back Problems YesNo
Joint / Bone problems YesNo
Arthiritis YesNo
Nerve Problems YesNo

6. Have you ever been diagnosed with:
Asthma YesNo
Diabetes YesNo
Epilepsy YesNo

7. Do you know of any other reasons to why you should not undertake physical activity?
YesNo

8. Date of birth (DD/MM/YYYY): / /

Health & Safety Agreement

I hereby state that I have read, understood and answered honestly the questions above. I realise that my participation in these activities involves the risk of injury and am aware that I am participating at my own risk. I understand that it is my own responsibility to seek medical advice and doctor’s consent before taking part in this event, should I have ticked yes to any of the above medical questions.

Sign

Please type name below to confirm the above information is correct to the best of your knowledge

If you would like to see full details of our data practices please visit our Privacy Notice and if you have any questions please email data.protection@midsnell.co.uk.