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Summer Body Challenge Registration
Registration for Summer Challenge 16 September 2023
* Indicates required question
Name
*
Your answer
Email
*
Your answer
Phone number
*
Your answer
I would like to sign up for:
Choose
8 Week Challenge
12 Week Challenge
Undecided
Please explain your main goals for this Challenge:
Your answer
Height?
Your answer
Weight?
Your answer
How many times per week do you currently exercise?
Your answer
How would you describe your job in terms of activity?
I sit the whole day
I move around quite a bit in my job
I am very active in my job
Do you know how many steps you take on average per day?
Your answer
How would you describe your current eating habits?
Your answer
On a scale of 1(lowest) and 10(highest), how would you describe your stress levels?
Lowest
1
2
3
4
5
6
7
8
9
10
Highest
Clear selection
How many hours of sleep do you get per night on average?
Your answer
How many days per week do you consume alcohol?
Every day
Once a Week
Never or Very Occasionally
2 - 3 Times per Week
Other:
Clear selection
Do you have any food intolerances or allergies, or are you vegan or vegetarian?
Yes
No
Other:
Clear selection
Is there any medical reason for you not to follow an eating plan? eg, Diabetes, eating disorders or other medical condition?
Your answer
Any other information that you would like to share?
Your answer
Thank you for completing the form, please make your payment into the HIIT Studio Account: HIIT STUDIO, Nedbank, Acc no: 1190593726, Woodlands Branch. Reference: Name + Summer.
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