pink pilates - giving women with breast cancer strength

Mon, Sep 6, 2010, 4:13 am

Please fill out the below form if you would like to participate in the Pink Pilates Programme, become a Friend of Pink Pilates or would like to sign up to receive our newsletter:
(required form fields are bold)

First Name:

Last Name:

Email address:

Phone number:

Address:

I would like to participate in the Pink Pilates Programme:
I would like to receive a Pink Pilates Welcome pack:
I would like to sign up for the Pink Pilates news letter:
I would like to join Team Run for your Life:
I would like to volunteer and become a Friend of Pink Pilates:
I would like to become a Pink Pilates sponsor:

How did you hear about us?

Friend	Magazine
Medical professional	Internet
Referral	Other

Security Number:

Enter Security Number:

Contact Details:

Physical Address:
PINK PILATES HEAD OFFICE
@ The New Zealand Breast Cancer Foundation
11 - 13 Falcon St
Parnell

Postal Address:
THE PINK PILATES TRUST
PO BOX 37411
PARNELL 1151

Phone/email and web details:
DDI 09 304 0969
lou@pinkpilates.co.nz
www.pinkpilates.co.nz

"I was fortunate to be doing Pilates both before and after my mastectomy. As a result my healing and ability to get back into life with 3 small children was quite immediate. Pilates gives me both physical strength and a belief that I am in control of my disease, not the disease controlling me."
Anna Williams