Application Form
Ready to Get Fit & Stay Fit? Apply Now to Join the Exclusive GAZFIT 360 Program and Take the First Step Towards A Better You.
Name
First Name
Last Name
Email
example@example.com
Phone Number
Please enter a valid phone number.
Age
Gender
Female
Male
Prefer not to answer
Other
Do you have any medical conditions or injuries?
Yes
No
Please give details (Leave blank if answer is no)
Current weight
Current height
Please list the goals according to your priority. (First 3 option will be prioritized.)
Please select your plan
£39/month: GAZFIT360
£199/month: GAZFIT360 Premium
Tell me why you want to join GAZFIT 360? Everyone in the program is hand-picked by myself, so I want to know what drives you, what your goals are, and why you think you're ready to transform. The more honest and detailed, the better :)
How motivated are you to change ?
Not much
1
2
3
4
LETS GO!!!!!
5
1 is Not much, 5 is LETS GO!!!!!
START!
Should be Empty: