Clone of Queen Fit Collective Interest Form (Lock-In)

Queen Fit Collective The Next Level

A How You Living Healthy Initiative 2026-2027
Queen Fit Collective — Phase 2 Registration

A How You Living Healthy Initiative

Welcome to Queen Fit Collective! We empower women ages 50+ through fitness, prevention education, healthy aging, accountability, and community.

This is YOUR cue to be ALL IN! 💚💜🖤

Phase 2 is your opportunity to renew your commitment to your health, build strength, and grow in sisterhood. Whether you’re returning or joining for the first time, you belong here. Start where you are, move at your own pace, and let’s encourage one another along the way.

✨ Here’s what to expect:

👑 Fitness that fits your lifestyle: Fun activities with options for different fitness levels.
👑 Local meet-ups: In-person workouts, walks, and Queen Fit gatherings.
👑 Prevention education and healthy aging: Conversations and practical tips to support your well-being.
👑 Accountability and sisterhood: Encouragement, check-ins, and a community cheering you on.
👑 Self-paced workouts and Power Zooms: Virtual opportunities to stay connected—coming soon!

All new and returning participants must complete Phase 2 registration. Complete this form to join us as we move forward together! 💪🏾👑
Participant Information
Are you a new or returning Queen Fit participant?
Full Name

First NameLast Name
E-mail
County
Phone Number

Area CodePhone Number
Date of Birth

MonthDayYear
Age
Medical Release & Disclaimer
By choosing to participate in the Queen Fit Collective Phase 2 registration, I acknowledge and understand that:

I am voluntarily engaging in physical activity and wellness practices at my own risk.

It is my responsibility to consult with my physician before beginning any exercise, nutrition, or wellness program.

I understand that Queen Fit Collective, its organizers, and partners are not liable for any injury, illness, or other health-related issues that may occur as a result of my participation.

I accept full responsibility for my health, well-being, and personal safety during all activities (virtual, self-paced, or in-person meet-ups).

Participation is optional, and I may modify or stop at any time according to my own needs.

By joining, I agree that I am participating at my own risk, and I release Queen Fit Collective and its affiliates from any liability.
Emergency Contact Name

First NameLast Name
Emergency Contact Phone
Please enter a valid phone number.Format: (000) 000-0000.
Please acknowledge that you understand the above release form and then electronically sign below.
Signature
How would you like to participate?
What could make it difficult for you to participate consistently?

Other
Are there movement modifications or accessibility needs you would like the instructor to know about?
What is one commitment you are making to yourself for Phase 2?
How would you prefer to receive Queen Fit updates?
Primary Wellness Goals

Other
Program Interests
T-Shirt Size
Photo/Media Release
How did you hear about us?
Queen Fit is grant-funded program of the Family Service Agency, Region 9 Prevention Providers. Monthly activity plans will be provided. Attendance is encouraged. Respectful participation is expected.
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Queen Fit Collective The Next Level

Participant Information