"*" indicates required fields We are collecting your personal information in accordance with the Information Privacy Act 2009 for the purpose of processing this application/request. The information will be only accessed by authorised employees. Your information will not be given to any other person or agency unless you have given us permission, or we are required by law.Name* First Last Email* Phone*I am registering for the:* Rural Active Women program Rural Active Men program Cardio and Strength Circuits — 9.00am–10.00am Tuesdays at Merriland Hall, Atherton 11 March to 1 April 20 May to 10 June Hydrotherapy — Wednesdays 30 April–21 May, Atherton Pool 11.30am–12.15pm 12.30pm–1.15pm Core Strengthening Pilates, Chair Aerobics and Zumba — 9.00am–10.00am Thursdays at Merriland Hall, Atherton 13 March to 3 April 22 May to 12 June Cardio and Strength Circuits on 10.15am–11.15am Tuesdays at Merriland Hall, Atherton 11 March to 1 April 20 May to 10 June Where did you hear about the program?* TRC Social media Word of mouth Local Matters e-newsletter Newspaper Radio Filled out an EOI at the Age Friendly Expo and were contacted by TRC Other Please specify.*By submitting this form you are agreeing to the conditions of our photo, filming and recording consent. If you do not wish to be filmed, photographed or recorded, please notify the organiser on arrival.