Simply Energized Eating Program Registration
Name: *
Mailing address: *
Email address: *
I would like to register for: *
Please tell me why you're taking this course (it helps me customize the content for each group.) What are the major results you hope to achieve? *
Do you currently follow a specific eating style (e.g. vegan, paleo, gluten-free, etc)? *
If you responded "yes" above, please specify which eating style(s) you are currently following: *
I have read and agree to the terms of the following documents and understand that the Simply Energized Eating program is for educational & informational purposes only and is *not* intended to assess, diagnose or treat any disease or condition *
I understand that this course is only open to current residents of Canada *
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