Active24 North
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Active - Registration Form
Welcome to the Active24 North at Mernda Park Primary School, 40 Riverdale Blvd, Mernda VIC 3754.
At Active24, we help people live a Healthy Active Lifestyle through Fitness & Nutrition. All group fitness sessions are $5, this includes a post workout Hydrating Energy Beverage & Nutritional Protein Shake. We know how important it is to re-hydrate, re-energise, and re-fuel our bodies with the required nutrition (vitamins, minerals, complex carbohydrates, amino acids & protein), after each workout to assist us with an effective recovery.
You will challenge yourself to achieve your desired goal(s). Remember that you are only competing against yourself by working towards creating the best version of yourself. Your level 10 best!
We have a team of dedicated Wellness Coaches who are passionate about helping people in the community live a Healthy Active Lifestyle. Please refer back to your Wellness Coach and they will guide and assist you towards achieving your Health, Fitness and Weight goals.
Please complete your details below:
First Name
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Your answer
Last Name
*
Your answer
Address
Street Number & Name
Your answer
Suburb
Your answer
Postcode
Your answer
Email Address
*
Your answer
Mobile Phone
*
Your answer
What is the best time of day/evening for your Wellness Coach to follow-up with you?
Morning 9am-12pm
Afternoon 12pm-3pm
Late Afternoon 3pm-6pm
Evening 6pm-9pm
Other:
Is this your first time at an Active24 Fitclub?
*
Yes
No
How did you hear about us ?
Flyer
Facebook
Email Invitation
Referred by friend
Other:
Clear selection
If you answered Referred by friend in the previous question Please enter friend's name
Your answer
If you were invited by Wellness Coach Please enter coach's name
Jenny-Lee Clencie
Kris Nedelkoski
Peter Kokoulos
James Tsagros
Other:
Clear selection
If you have any friends or family members that you’d like to recommend, please provide their name and number below and we will contact them for their complimentary Wellness Evaluation.
Please enter Name, Mobile, Relationship to you (one entry per line)
Your answer
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