Booking Request

Course:

Name *

Email *

Phone *

Year of Birth*

Are you able to walk at a moderate pace, with rest breaks, for around 20 minutes?

Do you have a health condition or disability that affects your balance or ability to walk easily?

Please briefly explain your health condition or disability: *

Where would you prefer lessons

Please note your preferred availability: (days of the week, weekend, morning, afternoon) *

Are you a health care card holder, disability card holder, or a student?