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ONLINE FITNESS PRE-REGISTRATION FORM

NAME
TELEPHONE
EMAIL
AGE	11-20 21-30 31-40 41-50 51-60 61-70
GENDER	MALE FEMALE

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PLEASE RATE YOUR CURRENT LEVEL OF PHYSICAL FITNESS:	LOW AVERAGE HIGH

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HOW MANY SESSIONS WOULD YOU LIKE TO HAVE EVERY WEEK:	1 2 3 4 5

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WHAT ARE YOUR FITNESS GOALS:
WEIGHT LOSS / BODY TONING INCREASE STRENGTH & POWER CARDIO FITNESS MORE ENERGY INCREASE FLEXIBILITY QUALITY OF LIFE HEALTH & WELLNESS EDUCATION INJURY RECOVERY

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PLEASE LET US KNOW WHEN YOU WOULD PREFER TO WORKOUT:
WEEKDAY MORNINGS WEEKDAY AFTERNOONS WEEKDAY EVENINGS WEEKENDS

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PLEASE SELECT ONE OR MORE OF THE WORKOUTS AVIALABLE:
KETTLEBELL TRAINING BOOT CAMPS FITNESS KICK-BOXING BOSU BALANCE TRAINING CIRCUIT / INTERVAL TRAINING TRX SUSPENSION TRAINING BODY BAR PUMP PLYOMETRICS FREE WEIGHTS MEDICINE BALL TRAINING RESIST-A-BALL TRAINING SENSATIONAL STRETCHING

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