East Ayrshire Leisure |
 
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Contact Details

Title


First Name   (*)

Surname   (*)

Gender malefemale

Date of Birth   (*)
format:dd/mm/yyyy


E-mail Address   (*)

Phone Number   (*)
(we may need to contact you at short notice)
Home

Mobile

Password - minimum 8 characters   (*)

Confirm password   (*)

 

 

Address Details

Address line   (*)


Address line 2



Town / City   (*)

County

Postcode   (*)

Country   (*)
Contact Preferences
We may need to contact you if a class or show is cancelled. How would you like to hear from us?
(select all that apply)
(please note that by NOT selecting email, you will be unable to utilise our online booking function or receive booking confirmations).
Email   Phone   Post
 
Marketing Preferences
Do you consent to photographs / videos being taken / used by EAL?
YesNo
 
Would you like to join our mailing list for information about events, activities, special offers, news and more?
YesNo
 
How would you like to hear from us?
Email   Post
 
Would you like to be added to our emailing list? (select all that apply)
  • Countryside
  • Culture
  • Sport

(*) mandatory fields
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