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Fit, Fun & Fully Alive! Group Fitness Classes for Older Adults Group Registration Form

*Indicates a required field

Please complete this registration form and more details will be emailed to you regarding participation in our online classes.

You can call ConnectWell Community Health - Renfrew County Sites for more information – 613-582-3685.

 
 
e.g. 12/03/1955
Telephone Number (Please provide only numbers where you permit us to call
Please provide only email that you permit us to use to contact you.
Emergency Contact