Register for Get Active in Northamptonshire

Looking to Get Active? Order your free information pack full of information about how you can get more active in Northamptonshire. It's packed full of handy hints and tips on how you can build 30 minutes of activity into your day. By registering for the Get Active in Northamptonshire camaign, we will also track your levels of activity to motivate you to become more active by sending you regular updates and reminders!

First Name

Surname

Postcode

I'll enter this address manually

Telephone

Gender

Female
Male

Age

16-24
25-34
35-44
45-54
55-54
65-74
75+

Ethnicity

Do you have a longstanding illness or disability?

Yes
No

Have you taken part in any sport or active recreation in the last four weeks?

Yes
No

How many days per week do you undertake a total of at least 30 minutes of moderate intensity physical activity? (an activity that leaves you feeling warm and slightly out of breath)

None
1
2
3
4
5
6
7

How would you best describe the type of physical activity you do?

Sports and Active Recreation (e.g. the gym, sports and walking for leisure)
Active Travel (e.g. cycling or walking to work)
Active Lifestyle (e.g. housework or gardening)

Would you be interested in taking part in taster sessions or receiving information on: (please tick as many that apply to you)

Health Walks	Dance
Keep-fit	Gym/workouts
Badminton	Swimming
Tennis	Running/jogging
Cricket	Rugby
Football	Netball
Hockey	Other

For monitoring and evaluation purposes only, we would like to track your levels of activity with a short follow-up electronic questionnaire. If you do not want to be contacted then please tick the box

This information may be used by Northamptonshire Sport and partners. If you do not want to be contacted, receive information about future sport and leisure events or have your information shared, please tick the box

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Register for Get Active in Northamptonshire