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Please ensure that you read the form carefully and complete ALL questions

Please note that there will be a registration fee of £25 payable at the initial meeting on Monday 6th February.

Applications must be received by midday on Friday 27th January.

I have read the Terms and Conditions and agree to adhere to them should my application be successful.
I agree to the Terms and Conditions
*by providing your email address you are agreeing to being contacted by this method.
Sex

Have you ever been diagnosed with or treated for an eating disorder

Are you aware of any health reasons – or any other reasons – that might prevent you from doing or increasing the level of your physical activity?

Have you had any operations in the last five years?

Do you suffer from back pain?

Do you have any existing health conditions that will affect your ability to lose weight or exercise? (e.g, diabetes, asthma, epilepsy, bone/joint/back problems

Do you suffer from any allergies or intolerances (e.g. wheat, dairy)?

Do you have a heart condition?

Are you currently taking any prescription medication, including antidepressants?

Are you pregnant, or do you have a child under six months old?

Please Note:

  • To ensure that your application is considered, don't forget to email a photo of yourself to biggestloser@stfrancis.org.uk with your full name.
  • You can also include additional information about yourself to back up your application when emailing your photo to us.

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