Health and Fitness Registration 18th July

Health and Fitness Challenge Registration

* Indicates required field

Name *

First

Last

Gender *

Male Female

Height (metres) *

Weight (kgs) *

Date of Birth (dd/mm/yy) *

Email *

Is there anything related to your health that may affect your ability to complete this 12 Week Challenge for example: - heart trouble, high blood pressure, asthma or breathing difficulties? *

How would you describe your current level of fitness? *

What are your health and fitness goals? *

What (if any) exercise do you like doing? *

What (if any) exercise do you hate doing? *

What (if any) exercise equipment do you have access to? *

Your Address and phone numbers *

Emergency Contact details *

Submit

Health and Fitness Challenge Registration﻿

Health and Fitness Challenge Registration