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Registration of Interest
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below and answer the 2 questions. Completing this form submits your interest in receiving a 3 month complimentary membership at Fervid Fitness in Flint. PLEASE NOTE: YOU ARE NOT ELIGIBLE FOR THIS SCHEME IF YOU ARE ALREADY A MEMBER OF THE GYM.
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Full name
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Your answer
Mobile number
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Your answer
Email address
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Your answer
Address
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Your answer
Sex
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Male
Female
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Prefer not to say
Other:
Age
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Your answer
Are you currently physically inactive? (This means completing less than 30 minutes of moderate exercise per week)
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Yes
No
Do you class yourself as suffering from depression?
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Yes
No
Do you consent to be contacted by a member of Wrexham University about using your data for research purposes? Do not worry, your data will not be shared with anyone, if you do not consent, you can not take up the free membership offer
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Yes
No
Are you currently receiving any help for your mental health?
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Yes
No
Other:
If the answer to the above question is YES, what support are you receiving?
Your answer
Are you currently being prescribed anti depressants?
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Yes
No
If the answer to the above question is YES, what dose and type of anti depressants have you been prescribed?
Your answer
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