Email *

Date of birth *

Full Name *

Today's date *

Emergency contact: name, phone number and relationship *

Has your doctor ever told you that you have a heartcondition, or have you ever had a stroke? *

Yes

Do you ever have unexplained pain in your chest at rest or during physical activity or exercise? *

Yes

Do you ever feel faint, or have dizzy spells during physicalactivity or exercise that cause you to lose balance? *

Yes

Have you had an asthma attack that needed immediate medical attention at any time in the last 12 months? *

Yes

If you have diabetes (type 1 or type 2), have you had trouble controlling your blood glucose in the last 3 months? *

Yes

Do you have any diagnosed muscle, bone or joint problems that you've been told could get worse with physical activity or exercise? *

Yes

Do you have any other medical condition that may make it dangerous for you to exercise? *

Yes

If you answered Yes to any question above, please give more detail:

To the best of my knowledge, everything I have provided on this form is true and correct.

Your agreement *

I have read and understood these Terms & Conditions and agree to them.

Do you have a friend who you think would benefit from working with us too? Or is there someone you'd like to bring with you on this journey? If someone you refer signs up, you get $300 cash paid straight to your bank account.

Their name and number:

Choose your plan

Prices are per fortnight + GST. Nutrition coaching is included free with 2x and 3x per week. Your first fortnight is charged today, then every 2 weeks.