Tick to confirm you agree...

I am ready to make a lifestyle change

I agree to commit to the programme for 6 weeks

I agree to follow the nutrition plan provided

I agree to attend 3 exercise sessions per week. If I miss a session, I will complete one of the home exercise sessions provided.

I agree to ‘check in’ on Facebook during every exercise session attended

Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Date of birth

MM

DD

YYYY