JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.
BIM VIRTUAL GROUP CLASS SIGN UP
Please fill out the below form to let us know which services and/or products your are interested. Once you have completed this form our coaches will be reaching out to you ASAP.
Sign in to Google
to save your progress.
Learn more
* Indicates required question
Email
*
Your email
Your Name
*
Your answer
WHAT'S IT GONNA BE?
I'm all in! Sign me up for the 3x/week membership at $27/week
I'm mostly in and want to try a 10 pack to start for $80
I will do drop-ins for now <- you can buy these directly online at $9 per class (Sunday's are $8!)
Are you interested in purchasing any of the following? (We only have a limited supply. Tax not included.)
6 inch foam roller $39.99
12 inch foam roller $50.00
The stick roller $60.00
Lacross Ball $5.00
Yellow mini band (light) $6.00
Green mini band (medium) $6.00
Blue mini band (heavy) $7.00
Black mini band (extra heavy) $7.00
Orange rip cord resistance band (light) $25.00
Green rip cord resistance band (medium) $25.00
Red rip cord resistance band (heavy) $25.00
Blue rip cord resistance band (extra heavy) $25.00
Would you like to opt in to a free nutrition series? It's a 1 month program that we have created for our nutrition clients. Enter your email and we will add you free of charge.
Your answer
Do you have any other ideas of anything else we could do to support you?
Your answer
Do you want to tell us a joke?
Your answer
Send me a copy of my responses.
Submit
Page 1 of 1
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
Privacy
Terms
This form was created inside of Balance in Motion.
Report Abuse
Forms
