6-Week Challenge - Iron Studio Gym

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6-WEEK FITNESS CHALLENGE REGISTRATION FORM

Name*

Last Name*

Gender*

MaleFemale

Date of Birth*

Age*

Height*

Weight*

What do you do for a living?*

Whats the activity level at your job?

None (seated only)
Moderate (light activity such as walking)
High (heavy labor, very active)

List your physical activities outside the gym and work*

Any diagnosed health problems*

Any medications? Please list*

Any injuries?*

Are you a cigarette smoker?

Yes No

What is your fitness goals?

Improved health Increased muscle mass
Improved indurance Fat loss
Increased strength

Other goals?*

Are you currently training 3x per week or more?*

At what times during the would you prefer to train?

Morning Evening
Afternoon

1.) CANCELATIONS

Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

2.) LATE ARRIVALS

Each session shall be 1 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

I AGREE TO THE INFORMATION I HAVE GIVEN IS CORRECT!*

YesNo

BANKING DETAILS (please use your name and surname as refference)

Iron Studio Gym - FNB
Acc nr: 6255 0243 689
Branch code: 230146

PROOF OF PAYMENT