FIT BY DESIGN - Registration
This is for all Fit By Design Participants. Please fill this in prior to coming to your first class
Your name *
First name, surname
What's your email address? *
We will not give this to anyone else, but we might need to contact you
What's your phone number? *
Tell us a bit about you.... *
Your date of birth, job, hobbies, kids etc?
What is your current fitness routine? *
Walking... biking...swimming... nothing? Be as specific as possible
List 3 personal/external barrier to your success in this program *
(family, work etc..)?
Is there anything specifically you would like covered during our time together? *
Please list any injuries, surgeries, medial conditions or chronic pain that limit your physical activity? Please be specific.. *
Did someone recommend you to this program?
If so, who?
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