Parkinson's - Sign Up Form
  • Parkinson's - Sign Up Form

    Chelsea FC Foundation
  • Chelsea FC Foundation - Parkinson's Walking Football sessions

    Details:

    When? Mondays 10:30am-11:30am

    Where? Pitch 2, Westway Sport & Fitness Centre, 1 Crowthorne Rd, London, W10 6RP

    What? Casual Walking Football sessions for people living with Parkinson's. These sessions will involve warm up football drills/exercises/games specifically tailored to improve motor symptoms like balance, coordination, and flexibility, while also boosting cardiovascular health and strength.

    Cost? £0 (free!)

     

    Chelsea FC Foundation - Exercise & Mobility sessions

    Details:

    When? Wednesdays 15:00 - 15:45

    Where? Charing Cross Sports Club, Aspenlea Rd, London, W6 8LH

    What? Exercise & Mobility sessions for people living with Parkinson's. These sessions will involve a series of exercises specifically tailored to improve motor symptoms like balance, coordination, and flexibility, while also boosting cardiovascular health and strength.

    Cost? £0 (free!)

    Please Note: Due to reduced space within the venue, the maximum capacity for this class will be 10 participants. 

  • Which session are you signing up for?*
  • Personal Information

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  • Emergency Contact 1: Relationship to Participant*
  • Emergency Contact 2: Relationship to Participant
  • Medical Information - Pre-Existing Conditions (in addition to Parkinson's diagnosis)

  • Does the participant have any pre-existing medical conditions?*
  • Is the participant affected by any of the following conditions? Please select all that apply
  • Recent Injuries

  • Are there any particular exercises the participant should avoid or any exercise that would be particularly beneficial?
  • Medical Information

    Allergies and Medication
  • Does the participant suffer from any allergies?*
  • Is the participant taking any medication?*
  • Consent

  • Photos and videos of you may be taken at the Activity (the Images).The Foundation would like to use the Images to promote the work of the Foundation and grant Chelsea Football Club the right to do the same. This use may include print advertising, digital advertising and/or inclusion in presentations to partners, funders and other charitable organisations the Foundation works with or wishes to work with.*
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