First Name
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Last Name
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Email
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Phone
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Date of birth
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Age
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Address
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City
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State
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Injuries/Medical Conditions Please record any injuries/medical conditions that will affect my fitness/health pursuits... If you have an injury, please designate right or left side of the body.
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Goals What are your health/fitness/nutrition goals? Learn how to lift weights? Improve athletic performance? If so, what specifically--speed, jump height, etc?
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Which services are you interested in?
App $29.99/Month (online program to do at-home)
Youth Sports Performance Group Training- 10-Sessions (Punchcard)
Monthly Group Classes $75/Month
Preferred Method Of Contact
SMS (Text) / Phone call
Email
Any
How did you hear about us?
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A friend referred me
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