Medium / Advanced Challenge Registration

12 Week Medium / Advanced Challenge Registration

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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? *

What are your health and fitness goals? *

Your Address and phone numbers *

Emergency Contact details *

Submit