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Gallery 22-23
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African Drumming
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Weekly Activities
Monday- Jubilee Court Breakfast Club 10am-12pm NG8 6LJ
Tuesday- Stanwick Close Game/Bingo 11am- 2pm NG8 3BX
Crafty Friday- Card Making
Registration Form
Date
First Name
Last Name
Phone Number
Email
Date of Birth (01/01/1960)
Address
Number
Address
Post Code
Do you require a carer for day trips
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No
Do you required mobility aid- please select
No
Walking Stick
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Scooter
Wheelchair
Ethnic Background
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English/Scottish/Welsh/Northern Irish/UK
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Gender
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Age Range
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0-4 years
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Sexual Orientation
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Please provide emergency contact name and phone number
How did you heard about Forever Young
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April
Word of Mouth
Friend or Families
Volunteer Community Champion
Social Media
Leaflet and Posters
Partnership working
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What are your interest (Choose-all-that-apply)
Socialisation ( Making new friends)
Improving Physical Health
Improving Well Being
Exploring/day trips
Arts and Crafts
General Advice and Information
Volunteering
Partnership Working
Best Method of Communication (Choose-all-that-apply)
Phone
Email
Facebook
Leaflet/Poster
Face to Face
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