Name*  

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Email address*  

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Health & Fitness goals - please enter what you would like to achieve within the next 6 months  

Are you exercising at the moment?:  
 Yes
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Would you be interested in receiving nutritional advice?:  
 Yes
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What activities are you interested in?:  
 Gym
 Group Exercise
 Swimming
 Racquet Sports

Would you be interested in a free day pass to try out our facilities?:  
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Which is your nearest leisure centre?   Please select:Pavilion Leisure Centre, BromleyThe Spa at BeckenhamWest Wickham Leisure CentreWalnuts Leisure Centre

How did you hear about us?*   Please select:Bromley Mytime WebsiteWebsite (other) Search EngineFacebookStreet PosterNewspaper advertThe Glades Shopping CentrePrevious UserFriend ReferralOther

If Other, please specify:  

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