6-Week Challenge - Iron Studio Gym
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6-WEEK FITNESS CHALLENGE REGISTRATION FORM
Name*
Last Name*
Gender*
Male
Female
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!*
Yes
No
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
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