Free trial

Thank you for your interest in trialling a class with e.motion21. We offer a variety of dance and fitness classes for people living with Down syndrome aged between 4 and 40 years. Please complete the following form and we will be in contact with you to confirm your free trial!

If you are unable to attend classes due your location, please specify this in the form below as we monitor interest in other locations.

Participant Details

Participant's Name *

Date Of Birth *

Gender *

Male

Female

Does the participant have Down syndrome? *

Note: we only offer classes to participants who have Down syndrome

Yes

Contact Details

Primary parent/carer name *

Your Address *

Country

City

State

Zip code

Phone/Mobile *

Email *

Preferred method of contact *

Would you like more information about our program and current classes available? *

Yes

Submit

Captcha *

reCAPTCHA is required.

Class location & type

Participant Details

Contact Details

How did you hear about us?

Submit