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The following form is long, but it does enable the instructor to know a little about you and advise on which class is best suited for you. Not all boxes may seem relavant if attending a Zumba class, so please just put N/A in those boxes. All information and data is treated with strictest confidence and NEVER disclosed to anyone else or sold on. Please visit the Terms and Conditions page as by filling this form in, you are agreeing to them.

ALL BOXES NEED TO BE FILLED with an answer, including the CAPTCHA at the end before form will submit. a green tick after submission, will let you know it was successful but you may have to scroll back up the page to see that.


Please take extra care when typing your EMAIL otherwise, the instructor cannot contact you back!!

If form does not load for you on your device, dont despair! - please email me

Data Privacy - By submitting this form you consent to this data being collected and stored for if you attend class. It will be deleted after 2 months if you have not attended or communicated with us in that time.


This form collects your name and email address along with your health information so that we can communicate with you and provide you with assistance and keep everything you do in class as safe for you as possible. We do NOT pass on or sell on your data and information.

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