EARLY BIRD 12 Week Challenge Signup

12 Week Performance Program Signup

Please fill in all fields with as much detail as you can. This will take approximately 3 minutes to complete.
Name

First NameLast Name
Email
example@example.com
Phone Number
Format: (000) 000-0000.
Date of Birth

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Height
cm
Weight
kg

Before We Proceed!
Is there any medical condition that may prevent you from participating in our 12 Week Program
If YES, Please Describe:
Our Training Sessions will be held MONDAYS & WEDNESDAYS at 7:15pm + SATURDAYS at 9:00am. Are you able to commit to attending AT LEAST 75% of these sessions?

Goal Setting

Let our coaches know what your training goals are:
What do you want to achieve by participating in our 12 Week Performance Program? (Be as detailed as possible here. These goals should include strength, aerobic, physical transformations as well as habit based goals. Examples: Be able to do 3 Pull-Ups, Run 3km in under 15 minutes. Have visible abs, Fit into Size 10 Dresses, Have a regular sleep routine and consistently get 8 hours of sleep each night.
Do you have any questions for our coaches ?

12 Week Performance Package (Early Bird)($115.00 AUD for each week)

12 Weekly Payments

I, {name4}, as a cardholder, hereby authorize Performance & Recovery HQ to charge my credit card {conditiontext} for 12 payments and confirm that the information for the credit card and billing address is complete and accurate.

I am aware that after the purchase of my order, there are no refunds
Date

DayMonthYear
2 digit day, 2 digit month, 4 digit yearDate
Athlete Signature
Should be Empty:

12 Week Performance Program Signup