DIY Healthy Lifestyles Center - Member Registration Form
Completing this form registers you as an official member of the DIY Healthy Lifestyles Center.

Your Welcome Gift Package will arrive at the email address you provide here once this form is processed. Please make sure to allow emails to your inbox from center@diyhealthylifestyles.com.

The information and answers you provide here is for Center use and is not shared with any third parties or with other members. Your information is kept strictly confidential and only you can share it with others if you so choose.

Email address *
Policies & Disclaimers - Check all that apply *
Required
Please Note
You will be asked two questions in your acceptance email that will verify that you read these pages. Checking that you read both pages then providing incorrect answers to the questions could result in your ineligibility for membership.
First Name *
Last Name *
Create a User Name for the Center or enter one you already use elsewhere *
1. What age group are you in? *
2. Where are you from? (city, state, province or region and country) *
3. What features are most important to you when searching for wellness information? (Check all that apply) *
Required
Other important features for me include:
Which of these five wellness topics interest you most? (Check all that apply)
What specific health and wellness topics would you most like to know more about? (Enter as many as you wish or if none, enter 'none') *
Where do you find most of your wellness information? (media titles, site names, names of authors, coaches, personalities) If you don't have sources to list, enter 'none' *
Post any questions or comments you have about the Center, or about things you'd like to see (optional)
Thank You for Your Membership!
Watch your email for your 'Welcome Package' -- make sure to whitelist support@healthylifestylesmedia.com to avoid missing your package.
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