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* First Name:
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* Last Name:
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* Email Address:
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* Phone:
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* Preferred method of contact:
Email
Phone
Please select a preferred method of contact.
* If phone, best time to call:
Morning
Early Afternoon
Late Afternoon
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* How did you hear about us?
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Word of mouth
I drive by everyday
Direct mail/postcard
Newspaper
Company referral
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* What are your personal fitness goals?
Lose weight / tone and firm
Gain weight and/or build muscle mass
Increase energy
Increase flexibility
Rehabilitation
Relieve stress
Sports performance
Social interaction
Please select at least one personal fitness goal.
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* Do you currently belong to a health club?
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Yes
No
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* Are you interested in personal training?
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Yes I am
I need more information
Not at this time
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* What amenities do you think you will take advantage of?
Exercise programs
Cardiovascular development
Aerobics
Yoga
Pilates
Ab conditioning
Kids cardio
Resistance training
Freeweight training
Proshop
Sauna
Free kids funtime center
Locker room facility
Tanning
Please select at least one amenity.
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What company do you work for?
Are you currently a student?
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Yes
No
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Is there anything you would like us to know?