MKLETSGETFIT

Full Name

First NameLast Name

Gender

Email

example@example.com

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Age

years

Weight

KG

Height

cm

What do you do for a living?

Whats the activity level at your job?

Do you follow a regular working schedule, do you work days, afternoon or nights?

Please list the physical activities that you participate in outside of the gym and outside of work.:

If you have any diagnosed health problems list the condition(s).

If you are on any medications, please list them.

If you have any injuries, please list them.

Are you experiencing any stresses or motivational problems?

Do any diseases run in your family?

Do you suffer from diabetes, asthma, high or low blood pressure?

if yes(to any of the 4 questions above please list: (the more detailed the better 🙏🏾)

Your current diet could be best characterized as:

What problems do you feel you face when dealing with your nutrition?

Please rate your readiness for change.

What following goals does best fit in with your goals?

What challenges do/have you faced trying to reach your goal?

Why would you like to achieve this goal?

How often are you willing to train a week to reach your goal?

Are you currently excersising regulary (at least 2x per week)?

Please rate your motivational level to do what it takes for reach your goal.

Are you financially ready to invest into your journey towards the best you today?

1.) CONTACT TIME.

I allow clientele to message me on a WhatsApp/Email/IMessage ONLY basis. Any other means of contact will not be responded too. Access time is from 10am - 18:00pm Monday -Friday. Weekends no contact unless scheduled by myself.

2.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I have sought and expressed any necessary medical advice. If anything is to change i shall inform "Emmanuel Katundu" immediately. I understand that all the information given will be kept confidential. I also acknowledge and accept all responsibility for any undesired situations during training. "Emmanuel Katundu" has informed me that i am the only responsible party for all injuries during the fitness program.

4) PAYMENTS

I acknowledge that this is a minimum 3-month commitment, consistenting of 3 payments of agreed price and chosen date. If i wish to cancel i shall inform "Emmanuel Katundu" but i still have access until the 3rd payment is recived.

ONLINE COACHING

STANDING ORDER PAYMENTS COME THROUGH FROM DATE OF PURCHASE AND ROLL ON EACH MONTH AT SAME DATE. YOU UNDERSTAND THE 1-2-1 IS A MINIMUM COMMITMENT OF 3 MONTHS! IF TO CANCEL PLEASE MAKE ME AWARE FIRST AND YOUR SERVICES WILL END AFTER THE 3RD AND FINAL PAYMENT IS RECIVIED, THIS WILL BE SAME FOR ACCESS FROM MY RESOURCES.

I AGREE TO THE ABOVE TERMS & CONDITIONS!

Signature

My Products

MKPT HYRBID 1-1

$150.00 Quantity

Total

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