Health Club Bootcamp Survey

Thank you for signing up for Total Body Bootcamp! Please answer the following questions to complete your registration and improve your bootcamp experience.

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* 1. Your Contact Information:

First Name

Last Name

Address

City/Town

State/Province

ZIP/Postal Code

Email Address

Phone Number

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* 2. What is your birthday?

Please list the day, month and year

Date

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* 3. What is your gender?

Female

Male

Prefer not to say

Other (please specify)

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* 4. Are you pregnant?

Yes

Not Applicable

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* 5. Do you have any injuries or physical limitations?

Yes

If yes, please explain:

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* 6. How many hours are you active weekly?

Two hours or less

Two to ten hours

Ten hours or more

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* 7. How did you hear about Health Club Bootcamp?

Health Club website

Facebook

Flyer

Friend (Please leave their name)

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* 8. What are your goals from the Bootcamp? (Check all that apply)

Accountability

Gain knowledge on exercise techniques and form

Weight loss

Strength building

Other (please specify)

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* 9. Are you a member of The Health Club? if so, how long have you been using a gym for?

Yes, less than 3 months

Yes, over 3 months

Yes, over 5 years

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* 10. Are you interested in personal training?

Yes

Maybe

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* 11. Do you prefer strength or cardio?

Strength

Cardio