Are you currently exercising:
Date of Birth
Your Name:
Your Phone No:
Your email:
Tell me about any health issues or injuries you have. (please select any that may apply:
Awesome thanks. We will be in touch to book you in and get you started.
Add any further comments or questions below, then click Submit. We will be in touch real soon.
So what are your small immediate goals & your ultimate goal:
FREE Trial
& Online Health & Fitness Assessment.
Anyone wishing to participate in a FREE Trial, must complete the following Assessment.

Below is a questionnaire to complete & submit One of experienced Personal Trainers will review & contact you with advice on which Programs would be best suited to your goals & Fitness level.
This information is only used for this purpose & will be held in complete confidence.
IMPORTANT NOTICE: It is wise to seek your doctor’s advice before beginning any health/fitness/nutrition program!
With doctors and physician support, are you able to participate in an exercise program?




Which Programs & Services you are interested in:
And finally when is the best time for you to make an appointment to pop in:

Not at allA couple times p/wk2-3 times p/wk3+ times p/wkMost days
High Cholesterol
High Blood Pressure
Heart or Lung Conditions
Hernia
Arthritis
Asthma or respitory proplems
Seizure Disorder
Diabetes
Back Pain
Neck Pain
Joint Issues or limitations
Recent Broken Bones
Recent Surgery
Muscular Disorders
Recent Injuries
Other:
YES. Click to agree
Pregnant or given birth recently
Any infectious Diseases
Take prescribed medication
Heart or Lung Condition
Group Fitness & Strength Classes
Yoga, Pilates, Meditation & Wellness Programs
Personal Training
Weight Loss Club
BOOTCAMPS
Kids & Family Classes
Natropath, Nutritionist, Myotherapist or Exercise Physiologist