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7 Day FREE Trial at Bellrose Location
CONTACT INFORMATION
First Name *
Last Name *
Phone *
E-mail *
GENERAL INFORMATION
How did you hear about American Physique Fitness Clubs?
Internet Search
Direct Mail
Close to Home
Close to Work
Referral from a happy healthy member
Banner or Billboard
What amenities will you utilize at our clubs?
Free Weights
Exercise Machines
Cardio-vascular Equipment
Group Exercise
Steam Room and Sauna
Personal Training
Nutrition Consultation
Do you have any medical challenges we can assist you with?
FITNESS GOALS
What are your fitness goals you would like to accomplish?
Lose weight and tone
Sports performance
Keep up with the kids (or Grandkids)
Doctors orders (Health reasons)
Relieve stress
Sleep better
Weight Gain (add Muscle)
Are you interested in Personal Training?
Yes I understand that is the fastest way to reach my goals
Not at this time perhaps in the future
No I understand exactly what to do
.
What is your current fitness level?
Beginner - Have never been in a workout program
Moderate - Have not worked out in quite some time
In good shape - Currently work out now and then
Very Good Shape - Workout frequently
.
Free 7 Day Pass
