Book Online

Personal Information

First Name:*

Surname:*

Maiden Name:

Sex*:
MF

Address:*

Postcode:*

Tel No*:

Mobile:

Date of Birth (DD/MM/YYYY)*:

Email:*

Course Details

Course Title:*
---YMCA L2 Certificate in Gym InstructingYMCA L2 Certificate in Fitness Instructing (Exercise to Music)YMCA L2 Award in Group Indoor CyclingYMCA L2 Certificate in instructing circuit trainingYMCA L3 Assessing Vocational Related AchievementYMCA L3 Award in Education and Training (PTLLS)YMCA L3 Award in Instructing BootcampYMCA L3 Diploma in Personal TrainingYMCA L3 Award in Nutrition for Physical ActivityYMCA L3 Award in Instructing Outdoor FitnessYMCA L3 Award in Sports ConditioningYMCA L3 Diploma in Exercise ReferralYMCA L4 Award in the Internal Quality Assurance of Assessment Processes and PracticeYMCA L2 Certificate in Gym Instructing - Distance learningYMCA L3 Diploma in Personal Training - Distance learningYMCA Award in Nutrition for Physical Activity Level 3 – Distance learningYMCA Award in Sports Conditioning Level 3 – Distance learningYMCA Awards Level 3 Diploma in Exercise Referral – Distance LearningYMCA Gym Instructor & Personal Training PackageYMCA ETM & Personal Training PackageAdvance Personal Training Package

Location:*

Start Date

Month:*

Year:*

Individual Requirements

Please indicate if you have any disability or medical condition that may require special arrangements for you. (This information is treated as private and confidential and will allow us to assist you as best we can)

If so do you require any additional arrangements to aid you in your training? Please detail below.

I accept the information provided on this form will be stored in accordance with the Data Protection Act 1998 for marketing and registration purposes.*

I give permission for my personal details to be sent to YMCA as required under the Data Protection Act 1998.*

I agree to the Terms & Conditions.* (opens in separate tab)