REGISTRATION FORM: NUTRILINE VIRTUAL WEIGHT LOSS CHALLENGE AND COMPETITION 2025 (SEASON 23)
Kindly complete registration for the above weight loss competition by providing answers to the questions below. We will send your meal plan to you a day to the start of the competition, once your registration fee has been paid. The registration fee for local clients is GHS 354.00 momo and International clients is GHS 404.00. MOMO number for payment is 0591601742. Add your full name and season 23 as the reference when making payment. Once we receive your completed form and payment we will get in touch with you regarding the next steps. Rules of the competition will be made known on the first day of the program via google meet. You may call 0208124004 for further enquiries.
Disclaimer:
By completing this form you agree that Nutriline and its entire management & staff will not accept any liability for ill-health, unmet expectations, loss, damage, injury to persons (self or others) arising out of participation in this competition. All participants of this competition hereby release Nutriline and its management & staff from any claims for ill health, un-met expectations, loss, damage, injury to persons (self or others) during or after the competition. 
If you have diabetes or any major organ disease or are pregnant/breastfeeding,  this competition is NOT for you. 
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Referred by? *
Full name *
Age *
Male or Female *
Required
Are you physically active?
If you answered YES to physical activity, how many days in a week do you engage in physical activity?
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How many minutes per day do you exercise?
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What  is your weight today? Indicate in kg or lbs *
Height (m) *
Whatsapp Telephone number *
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