Social Prescribing MOBY Young People Please enable JavaScript in your browser to complete this form.The Active Wellbeing Society delivers a wide range of free activities and support services for adults aged 18-30 years, in partnership with your GP practice. Your Social Prescribing Link Worker based at your surgery would like to share this support with you. Please complete the form below by selecting the areas you are interested in.For patients of the following GP Practices only:Yardley Wood Health Centre, Victoria Road Surgery, Wake Green Surgery, Baldwins Lane Surgery, Greenridge Surgery, Poplar Primary Care Centre, GP surgery *Yardley Wood Health CentreVictoria Road SurgeryWake Green SurgeryBaldwins Lane SurgeryGreenridge SurgeryPoplar Primary Care CentreName *FirstLastEmail Contact tel/mobile number: *AddressAddress Line 1CityState / Province / RegionPostal CodeDate of Birth *DD12345678910111213141516171819202122232425262728293031/MM123456789101112/YYYY2025202420232022202120202019201820172016201520142013201220112010200920082007200620052004200320022001200019991998199719961995199419931992199119901989198819871986198519841983198219811980197919781977197619751974197319721971197019691968196719661965196419631962196119601959195819571956195519541953195219511950194919481947194619451944194319421941194019391938193719361935193419331932193119301929192819271926192519241923192219211920Ethnicity *White BritishWhite IrishWhite PolishWhite otherAsian BangladeshAsian IndianAsian PakistaniAsian ChineseAsian otherBlack AfricanBlack CaribbeanBlack otherMixed Asian & BlackMixed Asian & WhiteMixed Black & WhiteAny other ethnicityRather not sayDo you have a disability *YesNoEmergency Contact Name *Emergency Contact Telephone Number *More information and details will be sent to you either via SMS or email in relation to the services you express interest in. Please note, there may be a fee due for some activities - We strongly advise you check at the time of registering with the organisation.Physical / Social GroupsGO (Great Opportunities) - ULTIMATE SOCIAL EVENTINGBreak DancingKings of Spain & friendsWhere these flowers grow (Poetry)Thrifty SaturdayFree Women's Tennis for Beginners - Moseley: Wednesdays 9:30-10:30Women's Tennis For Beginners - Billesley: Thursdays 1-2pmWeekly Cuppa and Social: MondaysLed Ride/Learn to Ride: Yardley: Sunday 19 March 2023Social Wellbeing/Running: Mondays - Sarehole Mill MuseumTrittiford Mill Pool Run & Walk group: WednesdaysSpringfield Centre: Thursdays Community Cooking SessionsSpringfield Centre: Thursdays Place of Welcome Share Shack - Calthorpe Park (Borrow Skates for Free soon!)The Old Print Works Moseley Road Baths - swimming tai chi Physical / Social Groups specifically upto 29 year olds:Run 4 Fun: Mondays - 2:30-3:30pmDance: Mondays - 6-7pmSocial Sports: Thursdays - 3-4pmEmployment Support:Employability workshopsMentoring for 18-29 year oldsYoung People Get Ready to Rise - Talent RiseGet Set sessions - Help MusiciansVolunteering Opportunities:LoveBrumGardening - The Active Wellbeing SocietyListen & Connect - The Active Wellbeing SocietyRunning & Walking Leaders - The Active Wellbeing SocietyMoseley Bog Nature ReserveBirmingham Community HealthcareWalking Groups:Birmingham WalkathonMoseley Bog: TuesdaysBillesley Indoor Tennis Centre: Fridays, MiddayBillesley Common: MondaysOther Support Services:Anawim - Birmingham Centre for Women Living Well Consortium - Mental Health SupportLocal Support/Interest GroupsTick to confirm *I agree to register for a Wellbeing CardThe Wellbeing Card is required to enable you to access the free activities through The Active Wellbeing Society. You will be issued with a membership card known as Wellbeing Card which you will receive in the post.Tick to confirm *You will be contacted by your social prescribing link worker via email-SMS with your chosen support services information. Your information request will be updated on to your medical records – if you give consent please tick the boxTick to confirm *I agree to the data protection policy of The Active Wellbeing Society. To view this policy please review below:Privacy Notice How information about you will be used Information you provide is collected and stored securely by The Active Wellbeing Society Limited (community benefit society registered with the ICO; Reg. No. ZA266982), who provide services on behalf of Birmingham City Council, Sport England, Our Health Partnership. We collect this information to enable us to administer the membership we hold with you, to provide better services, to promote public health and physical activity and monitor the effectiveness of our programmes, to maintain our accounts and records, to prevent fraud and misuse of public funds and to report to our funders. We will keep this information during the time of your involvement with our services and for a period of 3 years afterwards. We may share anonymous information about you with our partner organisations and funders, in order to provide you with appropriate services, to monitor outcomes related to physical activity and healthy lifestyles and to facilitate research and insight. We and our partners will hold this information in confidence and comply with all our responsibilities under the General Data Protection Regulation and Data Protection Act. By signing up, you agree to these terms. You have a right to withdraw your consent at any time at any time by contacting us on 0121 728 7030 or emailing [email protected]. If you would like a copy of our Data Protection Policy please visit http://www.theaws.org/privacy-notice Alternatively, you can find out more about your rights or complain to the Information Commissioner’s Office at ico.org.uk.Submit