Together we can improve your life
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1. Default Section

1. Name

Name

2. Email

*
3. Age Bracket

Age Bracket Under 20

20 -30

30 - 40

40 - 50

Above 50

4. What fitness activities are you currently involved in?. Eg gym, walk twice week, sporting team?

What fitness activities are you currently involved in?. Eg gym, walk twice week, sporting team?

5. Are you currently a member of a gym/fitness group?

Are you currently a member of a gym/fitness group? Yes

6. If yes, what do you like/disklike about your current fitness group/gym?

If yes, what do you like/disklike about your current fitness group/gym?

*
7. What is your motivation to exercise? (You can pick more than one)

What is your motivation to exercise? (You can pick more than one) Social (meeting people being with friends)

Get fit

lose weight

Increase Health

Increase sporting performance

Other (please specify)

*
8. Would you prefer to train indoors or outdoors?

Would you prefer to train indoors or outdoors? Indoors

Outdoors

Comment

9. When would you be most likely to train

	Mon	Tue	Wed	Thur	Fri	Sat	Sun
6am	*When would you be most likely to train 6am Mon	6am Tue	6am Wed	6am Thur	6am Fri	6am Sat	6am Sun
7am	7am Mon	7am Tue	7am Wed	7am Thur	7am Fri	7am Sat	7am Sun
930am	930am Mon	930am Tue	930am Wed	930am Thur	930am Fri	930am Sat	930am Sun
6pm	6pm Mon	6pm Tue	6pm Wed	6pm Thur	6pm Fri	6pm Sat	6pm Sun
7pm	7pm Mon	7pm Tue	7pm Wed	7pm Thur	7pm Fri	7pm Sat	7pm Sun

Other (please specify)

*
10. Here at Cipolla we have been looking at a variety of programs that will improve your life layer by layer. We are interested to know what programs you would like to attend

	Not interested	Maybe interested	Very interested
Boxing - great cardio work out using boxing equipment	*Here at Cipolla we have been looking at a variety of programs that will improve your life layer by layer. We are interested to know what programs you would like to attend Boxing - great cardio work out using boxing equipment Not interested	Boxing - great cardio work out using boxing equipment Maybe interested	Boxing - great cardio work out using boxing equipment Very interested
Cipolla Challenge - Form a team and compete against others to win the cipolla challenges.	Cipolla Challenge - Form a team and compete against others to win the cipolla challenges. Not interested	Cipolla Challenge - Form a team and compete against others to win the cipolla challenges. Maybe interested	Cipolla Challenge - Form a team and compete against others to win the cipolla challenges. Very interested
Core and Flex - so important to building strength, stability and strength	Core and Flex - so important to building strength, stability and strength Not interested	Core and Flex - so important to building strength, stability and strength Maybe interested	Core and Flex - so important to building strength, stability and strength Very interested
Cycle outdoor - beginner/novice cyclist learn how to ride in a bunch and increase your cycle skills	Cycle outdoor - beginner/novice cyclist learn how to ride in a bunch and increase your cycle skills Not interested	Cycle outdoor - beginner/novice cyclist learn how to ride in a bunch and increase your cycle skills Maybe interested	Cycle outdoor - beginner/novice cyclist learn how to ride in a bunch and increase your cycle skills Very interested
Cycle Tech - cyclists wanting to improve their technique and gain better results	Cycle Tech - cyclists wanting to improve their technique and gain better results Not interested	Cycle Tech - cyclists wanting to improve their technique and gain better results Maybe interested	Cycle Tech - cyclists wanting to improve their technique and gain better results Very interested
Mums and Bubs – X training - great workout for mums and they can bring their kids too	Mums and Bubs – X training - great workout for mums and they can bring their kids too Not interested	Mums and Bubs – X training - great workout for mums and they can bring their kids too Maybe interested	Mums and Bubs – X training - great workout for mums and they can bring their kids too Very interested
Mums and Bubs – running/walking - grab your pram your baby and lets go	Mums and Bubs – running/walking - grab your pram your baby and lets go Not interested	Mums and Bubs – running/walking - grab your pram your baby and lets go Maybe interested	Mums and Bubs – running/walking - grab your pram your baby and lets go Very interested
Phyometrics – Sports training	Phyometrics – Sports training Not interested	Phyometrics – Sports training Maybe interested	Phyometrics – Sports training Very interested
Strength and Conditioning - lets build/tone those muscles using weights and own body strength	Strength and Conditioning - lets build/tone those muscles using weights and own body strength Not interested	Strength and Conditioning - lets build/tone those muscles using weights and own body strength Maybe interested	Strength and Conditioning - lets build/tone those muscles using weights and own body strength Very interested
Walking group - recovering? need light exercise? want to join other walkers this is the group for you	Walking group - recovering? need light exercise? want to join other walkers this is the group for you Not interested	Walking group - recovering? need light exercise? want to join other walkers this is the group for you Maybe interested	Walking group - recovering? need light exercise? want to join other walkers this is the group for you Very interested
X training - mix of cardio/strength building	X training - mix of cardio/strength building Not interested	X training - mix of cardio/strength building Maybe interested	X training - mix of cardio/strength building Very interested
Personal Training - need one on one? fantastic way to meet your own goals	Personal Training - need one on one? fantastic way to meet your own goals Not interested	Personal Training - need one on one? fantastic way to meet your own goals Maybe interested	Personal Training - need one on one? fantastic way to meet your own goals Very interested
Small Group Training - have a friend that also needs personal training. This is the way to go!!	Small Group Training - have a friend that also needs personal training. This is the way to go!! Not interested	Small Group Training - have a friend that also needs personal training. This is the way to go!! Maybe interested	Small Group Training - have a friend that also needs personal training. This is the way to go!! Very interested
Mobile Service - can't get out, or prefer the privacy of your home we can come to you	Mobile Service - can't get out, or prefer the privacy of your home we can come to you Not interested	Mobile Service - can't get out, or prefer the privacy of your home we can come to you Maybe interested	Mobile Service - can't get out, or prefer the privacy of your home we can come to you Very interested

Other (please specify)

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Together we can improve your lifeExit this survey

1. Default Section

1. Name

2. Email

*3. Age Bracket

4. What fitness activities are you currently involved in?. Eg gym, walk twice week, sporting team?

5. Are you currently a member of a gym/fitness group?

6. If yes, what do you like/disklike about your current fitness group/gym?

*7. What is your motivation to exercise? (You can pick more than one)

*8. Would you prefer to train indoors or outdoors?

9. When would you be most likely to train

*10. Here at Cipolla we have been looking at a variety of programs that will improve your life layer by layer. We are interested to know what programs you would like to attend

Together we can improve your life
Exit this survey

*
3. Age Bracket

*
7. What is your motivation to exercise? (You can pick more than one)

*
8. Would you prefer to train indoors or outdoors?

*
10. Here at Cipolla we have been looking at a variety of programs that will improve your life layer by layer. We are interested to know what programs you would like to attend