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ONE WEEK TRIAL!

fill out the form below and click submit when you are finish for one VIP PASS! Make sure your e-mail address is correct. Include your full telephone number First Name* Street Address Last Name* City Home Tel. Work Tel. State Zip Your E-mail Country U.S.A. Argentina Australia Bahamas Barbados Bermuda Bolivia Brazil Brunei Darussalam Canada Chile Colombia Costa Rica Cuba Ecuador El Salvador England Spain Great Britain Guatemala Haiti Honduras India Ireland Israel Italy Jamaica Japan Mexico Nicaragua Panama Paraguay Peru Philippines Portugal Trinidad United Kingdom U S Minor Out. Isl Venezuela Wales Other (Note below) ================== Describe Your Job Active Stressful Inactive Long or odd hours Fitness History 1. How often do you exercise? Regulary Off and on Never 2. When was the last time you were on a regular exercise program? 3. How would you describe your eating habits? Good Fair Need improvement Fitness Goals Which Exercise benefits are most important to you? Look better Perform better Feel better What are your most important fitness goals? 1. 2.

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