HOME HOME NEW CLIENT REGISTRATION First name Last Name Email Gender Male Female Age Weight (KG) Whats the activity level at your job? none (seated only) Moderate (light activity such as walking) High (heavy labor, very active) How often you travel? Rarely A few times a year A few times a month Weekly Are you experiencing any stresses or motivational problems? Yes No Your current diet could be best characterized as: low-fat low-carb high-protein Vegetarian/Vegan No special diet What following goals does best fit in with your goals? Improved health Improved endurance Increased strength Increased muscle mass Fat loss Are you currently exercising regularly (at least 3x per week)? Yes No Please list the physical activities that you participate in outside of the gym and outside of work.: At what times during the day would you prefer to train? Morning Afternoon Evening Choose one of the following program to achieve your goal? Weight - loss Core Strength program Beach Body program Basic full body program Package Options Monthly subscription CAD $20 (4 workouts monthly) 18 sessions CAD $600 (weekly workouts + Diet charts + personal assistance) 8 sessions CAD $400 (weekly workouts + Diet charts) 4 sessions CAD $200 (weekly workouts + Diet charts) Personal video workout session CAD $30 Terms & Conditions 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. By signing this form, you will waive all claims, release of liability for any loss, damage or injury. 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 ABOVE TERMS & CONDITIONS! SUBMIT