John Chard-Young Legacy Fund - application for A.I.M Health & Wellness Centre sessions 

A.I.M Health & Wellness Centre sessions – these sessions can include access to the wellbeing suite where you are able to use exercise machines that are low impact and power assisted, under the guidance of instructors. This can be taken up as 12 sessions and must be used within a six-month period. Or, in partnership with Rockingham Forest Wellbeing, you can access holistic therapies such as osteopathy, sports massage, acupuncture and injury rehabilitation.  

Section 1 - Contact details

Person applying for sport sessions


This should be the address of the organisation. If the organisation doesn't have an independent location you can use the contact details of the primary contact.





The telephone number and email address should be one at which the organisation is easily contacted, especially during office hours


You must be a member of Adrenaline Alley and/or Active In Motion to apply
You must be a member of Adrenaline Alley and/or Active in Motion to apply to this fund. 
This fund is open to active members of Adrenaline Alley and Active In Motion, to qualify as an active member you will need to meet either of the following requirements:
  • Attended at least 2 Adrenaline Alley sessions within a 2 month period
  • Attended at least 4 AIM sessions within a 2 month period



If you are helping someone to apply, please provide your details:
If the individual applying for support is under the age of 16, please provide details of a parent/carer here.











Section 2 - Request for support


IMPORTANT: Please email garymcquade@activeinmotion.co.uk BEFORE applying for bungee fitness sessions if you have any of the following health related issues: Pregnancy or recent postpartum recovery, recent surgery, heart conditions or uncontrolled blood pressure, hernias, scoliosis, or spinal disorders, severe joint or musculoskeletal issues, vertigo, motion sickness, or seizure disorders, severe obesity (weight limits apply for equipment safety) 145Kgs is the maximum weight, respiratory conditions, uncontrolled diabetes, eye surgery, or cancer within the last 12 months.


Have you contacted your GP or community organisations to access support?
Section 3 - Supporting documents and Declaration
Supporting Documents
Please provide a recent copy of your bank statement with this application.


Declaration
I confirm that I meet the eligibility criteria listed in the guidance notes to apply to this fund. I give permission to Northamptonshire Community Foundation to record the information in this form electronically for the purpose of grant management. I give permission for Northamptonshire Community Foundation to contact Adrenaline Alley, Active In Motion, Rockingham Forest Wellbeing and/or other treatment providers (where applicable) to confirm and share information about my application. 

Contact Information