Shapes® Member Information Page

 

First Name

Last Name

Email Address

Best Phone Number

Date of Birth

How Did You Hear About Us?


Fitness History

Have You Ever Been Involved In An Exercise Program?
YesNo

If Yes—Tell Us More

How Long Have You Been Thinking About Starting An Exercise Program?

What Has Prevented You From Beginning or Continuing An Exercise Program In The Past?

In Which Are Would You Like To See The Most Improvement

If You Could Change One Part of Your Physical Appearance What Would it Be?


Peronal Information

Are You:
SingleMarriedDivorced

Describe Your Stress Level:
LowModerateHigh

Do You Have Children?
YesNo

If Yes What Ages:

How Many Days Will You Be Using The Facility?
1-23-45+

Tell Us Specifically Why You Stopped By Today?

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