FIT ISLAND New Registeration

FIT ISLAND FISTS AUSTRALIA

Sports & Training Service Registration
https://fitisland.com.au
Take Your Photo*
Full Name*

PrefixFirst NameMiddle NameLast Name
Guardian Name If Applicable
Father / Mother Full Name

PrefixFirst NameMiddle NameLast Name
How Young Are You?*

DayMonthYear
Gender*
Australia Contact Number:
+61 123 456 789
UAE Contact Number:
+971 12 345 6789
E-mail*
example@example.com
Address:*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Marital Status*
Signature*

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Are you under 18, please seek permission from your guardian to sign before completing the registration process. Sign again in case you are above 18*

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Select Preferred Date & Time to start a session*
* Please note. the selected date/time might be changed according to reservation availabilities
In case of emergency
Emergency Contact:

First NameLast Name
Relationship
Contact Number:
+971 123-123456
Weight (KG)
Height (CM)
Are you taking any medications, and if so, what are the side effects associated with them??*

YesNo
If yes, Please mention it here
Have you ever been told by a physician that you have heart disease, high blood pressure or any metabolic disease?*

YesNo
If yes, Please mention it here
Do you suffer from any problems of the lower back i.e. chronic pain, or numbness?*

YesNo
If yes, Please mention it here
Do you often feel faint or have spells of severe dizziness?*

YesNo
If yes, Please mention it here
Do you currently have any disability or other issues?*

YesNo
If yes, Please mention it here
Has your doctor ever told you that you have a bone or joint problems), such as arthritis that has been aggravated by exercise, or might be made worse with exercise?*

YesNo
If yes, Please mention it here
Has a doctor ever said your blood pressure was too high or too low?*

YesNo
If yes, Please mention it here
Has your doctor ever said you have heart problems?*

YesNo
If yes, Please mention it here
Has your doctor ever told you that you have Asthma, Epilepsy or Migraines?*

YesNo
If yes, Please mention it here
Are you or have you been pregnant in the last 6 months?*

YesNo
If yes, Please mention it here
ls there a reason, not mentioned here, why you should not follow an activity program even if you wanted to?*

YesNo
If yes, Please mention it here
Do you smoke tobacco or vape products?*

YesNo
If yes, Please mention it here
Do you take any supplements ?*

YesNo
If yes, Please mention it here
Do you have any existing or previous injuries?*

YesNo
If yes, Please mention it here
Do you have enough sleep every night?*

YesNo
If yes, Please mention it here
Have you worked out with a trainer before, and if so, what were the results?*

YesNo
If yes, Please mention it here
How much time are you willing to dedicate to your training?*

30Min / Day45Min / Day1 Hour / DayOther
If Other, Please mention duration here
Add any additional notes or comments
Where have you heard about us? *
Signature*

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FIT ISLAND FISTS AUSTRALIA

https://fitisland.com.au

Guardian Name If Applicable