Required fields are marked with an asterisk (*).
You must provide either a physical address, telephone number or email address for us to contact you to provide any additional information prior to the start of the program.
If you provide an email address, you will be emailed confirmation of your registration when you submit this form. If the program is cancelled for any reason,
a notice of cancellation will be sent to any email address provided.
Kansas Department of Health and Environment ↗
Arthritis Foundation ↗
Kansas YMCAs ↗