Move More Together Participant Form Section Move More Together Participant Form Thank you for your interest in Move More Together with SASP. This programme is all about connecting people through movement, whether this be at home, outside or in community facilities. Move More Together is part funded by Public Health at Somerset County Council and aims to support inactive older adults (50+) living with long term health conditions to take the first steps to increasing their activity. It is ideally suited to those who have lost confidence or become aware of changes to their mobility in response to the pandemic. Move More Together will match participants with volunteers who can support them to move more and reap the benefits to physical and emotional wellbeing. To register an interest in Move More Together, please share with us some details so we can get in contact, to understand your motivations and interests and discuss what happens next.Your personal data will be used and held securely only by Somerset Activity and Sports Partnership (SASP) as part of a contract with you to provide and administer the Move More Together programme. Your data will be securely deleted within 6 months if you notify us you are leaving the programme or you have not participated for 6 months, and where there are no legal or regulatory requirements. Images on the SASP website and social media sites can be viewed throughout the world and not just in the United Kingdom. Some overseas countries may not provide the same level of protection to the rights of the individual as EU/UK legislation provides. Images and recordings will be kept as long as necessary, and some images and recordings may be kept permanently as an archive of SASP activity. To find out more or to contact us about how we process data, please see SASP’s Privacy Policy at www.sasp.co.uk/privacy-policy. Name*: Full address*: Email address: Telephone number*: Preferred Contact: Telephone Email Date of Birth: What is your reason for joining Move More Together? Select all that apply*: Social/companionship Physical health Mental health Other Other How did you hear about Move More Together?* If it was through a Doctors Surgery please name the surgery. Move More Together has been designed to support older adults to become more physically active. So we can understand how active you are currently, please answer the following question: On how many days of the week are you physically active for at least 30 minutes? Physical activity is any movement that increases your heart rate and requires you to breathe faster.* - Choose - 1 x week 2 x week 3 x week 4 x week 5+ x week We understand that inactivity may be because you live with health conditions which can be unpredictable. To ensure SASP is clear on what level of support you require, please tell us how a volunteer can best help you*: Equipment: Setting up, adjusting, using, packing away Transitions: Moving between activities or exercises (please note we DO NOT expect volunteers to lift, carry or provide personal care, however volunteers may provide guidance where this essential e.g. partially sighted, unsteady on feet) Confidence: Motivation and reassurance Other Other
