2021/22 Summer Challenge Enrolment form

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Fill out the form below to get started and on track towards greater success & a healthier you!

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Email address *

First & last name

Address

What is your WHY? Why are you signing up?

What is currently stopping you from achieving your goals?

Which option are you signing up for?

Motivated - $35 (Challenge activities + FB Group)

Inspired - $85 (Challenge activities + FB Group + shirt or singlet)

Empowered - $115 (Challenge activities + FB Group + shirt or singlet + exercise band)

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Inspired & Empowered additional options - would you like a t-shirt or singlet?

T-shirt

Singlet

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T-shirt/singlet size (see below for size guides)

Singlet sizing guide

T-shirt size guide

Legal stuff - By Signing up to this challenge you agree to the following: *

That participating in this program is entirely at my own risk.

That I have my doctors permission to participate in this exercise program or that I have decided to participate without my doctors permission.

Acknowledge that participation in exercise activities carries with it potential hazard. You therefore release Empower Me Fitness & Consulting directors, volunteers, trainers and licensees and sponsors of any liability resulting from injury or death during the challenge or its related activities

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How did you hear about the challenge?

Enviar

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