St. Columba's Church Hall, Plas Newton, Chester, Cheshire, CH2 1SA, Tel: 01244 535788

Registered Charity 1123789

Emergency Contact Details
It is felt necessary by your Trustees that we have a note of an emergency contact for you. this will be retained with the membership records and will be available to the trainers of the various activities you attend.

It will only be used in an emergency when we need to contact someone on your behalf.

Please complete the form below which will be sent to the Membership Secretary

Contact Details

1st Emergency Contact Details

2nd Emergency Contact Details

Activities You Attend

Select all those that apply:

Bowls

Walking

Tai Chi

Exercise Class

Golf

Gymnasium

Chair Based

Strentgh and Balance