6 Week Fresh Start Registration Form

First Name *

Last Name *

Email (we will keep your email completely private) *

Best phone to reach you *

What type of class experience most appeals to you? Check all that apply. *

I just want to be able to make it through a 60 minute class.
I'm looking for a kick-butt workout.
I'm looking for direction and help in class from the instructor.
I want to be left alone in class.
I like large classes with lots of people.
I prefer smaller classes.
I like to meet other people and make friends.
I'm looking for motivation from the instructor.
I want a fun experience

What is your current exercise/physical status? *

I have never exercised my whole life.
I used to exercise but want to get back to it.
I currently exercise now.
I consider myself in poor physical shape.
I consider myself in moderate physical shape.
I consider myself in quite good physical shape.

Check off any of these concerns you have.

I'm afraid I may not be able to keep up in the classes.
I'm concerned there will not be others like me in the classes.
I'm afraid of getting hurt in the classes.
I'm concerned about maybe not being able to do the moves in class.
I'm afraid of getting too sore from the exercise.
I'm concerned people will not be friendly to me.
I don't think the classes will be challenging enough for me.
I think the classes might be boring.
I think the classes may be too easy for me

Any other concerns?

Are you excited to get started? *

Yes, of course!
No, I'm dreading this