Name *

First Name

Last Name

Level *

Please select ONE only The programme level you would like to follow. See the Online Programme page if you are unsure

Level 1 (beginner)

Level 2 (intermediate)

Level 3 (advanced)

Start Date *

When you want your programme to start

MM

DD

YYYY

Pre Activity Readiness Questionnaire *

Please read all the following questions 1) Has your doctor ever said you have a heart condition and you should only do exercise recommended by a doctor? 2) Do you feel pain in your chest when you exercise? 3) In the past month, have you had chest pain when you were NOT doing physical activity? 4) Do you lose balance because of dizziness or do you ever lose consciousness? 5) Do you have a bone or joint problem that could be made worse by a change in your regular physical activity? 6) Are you currently taking any medication for blood pressure or a heart condition? 7) Do you know of any other reason why you should not take part in physical activity?

I have answered NO to all questions and I am ready to start the programme

I have answered YES to one or more questions and will provide details below