Have you participated a past alumni class? If YES, you do not need to fill out the remainder of this form unless you have had a change in your medical status and you would like to update that specific question on the form.
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Type of Cancer & Year
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Medical Information - Please check if any of these apply to you:
If relevant, please explain the medical conditions you checked from above:
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Any other areas of pain or discomfort not mentioned above?
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Ability - Please check if these apply to you:
If relevant, please provide additional explanation of any of the statements you checked from above:
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Do you have any concerns regarding this class and/or your physical ability?
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Any suggestions for future class ideas?
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A copy of your responses will be emailed to the address you provided.