New Membership Request

New Membership Request

Use this form to apply for a membership. After you submit, we will contact you within 24 hours regarding the next step. Please direct any questions to strengthempirememphis@gmail.com or DM our Instagram (@strengthempirememphis). Thank you!
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
My interest is:*

PowerliftingBodybuildingStrongmanHighland GamesGeneral strength trainingOther
Tell us about your lifting background, experience, goals, etc.:*
Do you compete?*

YesNoNo, but I want to.
Do you have a coach?*

YesNoNo, but I want one.
What time of day do you typically work out?*

5am-9am9am-12pm12pm-2pm2pm-5pm5pm-7pm7pm-9pm9pm-5am
What days of the week do you typically work out?*

MondayTuesdayWednesdayThursdayFridaySaturdaySunday
Are you any of the following:

Military (active or not)First responder/medical (fire/police/EMS/nurse/etc)Educator/teacherType option 4
What is your Instagram handle?
Are you interested in any of the following:

Powerlifting teamOne-on-one personal trainingPowerlifting or general strength training programming
Are you 18 years or older?*

YesNo
How did you hear about us?
Should be Empty: