Fitness Class Application Form

Please fill the form carefully

Step 1

Step 2

Step 3

Full Name:

First Name

Last Name

Mobile No:

Email id:

Address:

Address Line1

Address Line2

Land Mark

City

State

Country

Zip Code

Date of Birth:

Sessions Per week:

Program:

Do you wish to have a personal coach:

Have you done any workout programs before:

When was the last time you have participated in physical fitness programs:

How do you rate yourself in terms of fitness:

Any allergic reaction to medicines (e.g. aspirin, penicillin, etc.):

Multiline TextAre you currently taking any prescribed medications:

Are you currently taking any prescribed medications:

Are you experiencing any epileptic seizures:

Have you had any operation in the last two years:

Please specify, which operation have you had:

Disclaimer

By checking this field and submitting this form, I confirm to the terms & Conditions