30 Day May Sweat & Shred Sign Up Form
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Physical Readiness Questionaire
*
Do you have chest pain when performing physical activity?
Are you pregnant or given birth in the last 6 months?
Do you have a bone or joint problem that worsens during/after exercise?
Have you had recent surgery?
Do you have any other limitations that must be addressed when developing an exercise plan (i.e. diabetes, high blood pressure, high cholesterol, arthritis, back problems etc.)?
Has your doctor ever said you have a heart condition and that you should only do physical activityrecommended by a doctor?
Do you lose balance because of dizziness or do you ever lose consciousness?
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Do you know of any other reason why you should not take part in physical activity?
None of the above, I am fit to take part.
If YES, please comment below:
Any questions please write them here. I'll be in touch soon! Thank you.
My Products
*
prev
next
( X )
30 Day Sweat & Shred
£
40.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
Signature
*
Clear
Submit
Should be Empty:
Now create your own Jotform - It's free!
Create your own Jotform