14 Day Trial
First Name *
Last Name *
Phone *
E-Mail *
How did you hear about us? *
 Our Website 
 Newspaper Ads 
 Direct Mailing 
 Friend Referral 
 Other 
Do you currently belong to a health club? *
 Yes 
 No 
...if Yes, what is the name of the health club to which you belong?
What amenities do you think you will take advantage of? *
 Personal Training 
 Group Training or Classes 
 Cardio Equipment 
 Strength Training Equipment 
 Traithlon Team Training 
 Juice Bar / Cafe 
 Steam Sauna 
 WiFi 
 Wellness Coaching 
 Nutrition Planning 
 LEAP Program 
 Les Mills Body Pump Class 
What are your fitness goals? *
 Lose weight and get tone 
 Gain weight/build body mass 
 Increase energy 
 Cardio conditioning/endurance 
 Increase flexibility 
 Rehabilitation 
 Relieve stress 
 Sports performance 
 Social interaction 

Additional Information (Optional)

Tell us a bit more to make your 14 day trial even better!
What are you overall expectations of your 14 day trial?
Additional Comments:
Powered byEMF Forms Builder
Report Abuse  

. . . . .