“The Jump Start To A Healthy Life”
How to Get Fit and Stay Fit for Seniors
Name
First Name
Last Name
Email
example@example.com
Phone Number
Gender
Male
Female
Do you have any pain which limits you from exercise?
Yes
No
How often do you exercise?
1-2 Days
2-3 Days
3-4 Days
4-5 Days
What type of exercises do you enjoy?
Weight Lifting
Stretching
Workout Classes
Yoga
What type of music do you enjoy while exercising?
Hip hop & R&B
Gospel
Country
AfroBeat
Other
How much do you enjoy exercise?
1 (least enjoyable)
2
3
4
5 (most enjoyable)
Other
“Let’s go Digital ”
Download your 5KF senior Wellness Get Back & Stay Fit program today!
Submit
Want to learn more about us? Visit
www.5keyfitness.com
and click on the Senior Wellness tab.
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