Registration request for Walk-Fit Class

Thank you for your interest in this event/program. Please complete and submit the form below.

Friday 3rd Nov 2023, 9:30am - 10:45am
Erin Indoor Rec Centre
184 Main St. Erin ON Click here for map
51 spaces remaining

Date of Birth:
Confirm email:
Phone Number:
Are you enrolled with one of our physicians?
How did you hear about this program?
I know that walking is a potentially hazardous activity. I should not enter a walking program if there is any known reason I should not be doing so.

I have read, understood, and completed the PAR-Q and YOU Questionnaire here and take full responsibility to discuss any related concerns with my family doctor.

I acknowledge the effects if indoor temperatures including air-conditioning, high heat, or that falls and contact with other participants are all risks being known and appreciated by me. In the case of inclement weather, it is my responsibility to check the East Wellington Family Health Team website at or call the clinic at 519-833-9396 to see if the program is running.  Having read this waiver and knowing these facts, I for myself and anyone entitled to act on my behalf, waive and release the East Wellington Family Health Team, and all their leaders, staff, and volunteers from all claims or liabilities of any kind arising out of my participation in these activities even if that liability may arise out of negligence.

If you cannot click "yes" please talk to your family doctor or provider.
Do you agree to the above statement(s)? Yes

By clicking "Submit", you agree to send this personal information to East Wellington Family Health Team online.

You agree to the Privacy Policy, which governs how your personal information is kept safe.