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Heilman’s Performance Online Plus
This form should be submitted by members wanting to join the Online Plus December Program.
$79 per month
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What day would you like to train at our Heilman's Performance facility?
*
If the times listed below do not work, please add a time that would work for you during our hours, and we will get back to you. Monday-Thursday 5:00-8:00 PM
Monday 5:00 PM
Monday 6:00 PM
Tuesday 5:00 PM
Tuesday 6:00 PM
Wednesday 5:00 PM
Wednesday 6:00 PM
Thursday 5:00 PM
Thursday 6:00 PM
Monday 7:00 PM
Tuesday 7:00 PM
Wednesday 7:00 PM
Thursday 7:00 PM
Other:
What is your name (first and last)?
*
Your answer
What is your email?
*
Your answer
What is your phone number with area code?
*
Your answer
What is your age?
*
Your answer
Were you referred by one of our members? If so, who referred you?
Your answer
Thank you for signing up for HP's Online Adult Program! You will receive further information about our program and an invoice for payment soon. If you have any questions or concerns, please feel free to email Courtney at
courtneyaheilman@gmail.com
or text her at 701-340-3931. We are excited to work with you!
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