In order to complete your registration, Please read the following waiver and indicate below you have read and understood this document.

I understand by agreeing, my signature is being transferred electronically, and I will not challenge the validity of the signature in any legal proceeding in which this document may be offered or used.

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* 1. I understand by agreeing, my signature is being transferred electronically, and I will not challenge the validity of the signature in any legal proceeding in which this document may be offered or used.

Last Name

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* 2. Last Name

First Name

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* 3. First Name

University ID No.

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* 4. University ID No.

Email

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* 5. Email

Department

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* 6. Department

Are you a UCLA Health/Med Center staff member?

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* 7. Are you a UCLA Health/Med Center staff member?

FIT Zone - Workouts for work breaks! These workouts are located close to where you work and are FREE for all UCLA Staff & Faculty. Sign-up, drop-in, and get active! These classes are designed to help UCLA Staff & Faculty manage stress; increase mental clarity and productivity; get fit, stay fit, and be well! 
Please select the classes that you are interested in attending. This is not a commitment to attend (you are free to drop in to ANY Fitzone class at any time without signing up). However, this helps us get a rough head count and helps us email specific updates for specific classes when announcements arise.

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* 8. Please select the classes that you are interested in attending. This is not a commitment to attend (you are free to drop in to ANY Fitzone class at any time without signing up). However, this helps us get a rough head count and helps us email specific updates for specific classes when announcements arise.

FIT Sports Use drop-in sports to get active and enjoy the camaraderie of your colleagues with FREE Lunch Time Leagues. Drop-in for a game or form a department team if you want!  Either way, it's easy . . . just show up at the gym with your UCLA ID and play! We apologize in advance for times when fields or courts are unavailable due to weather or maintenance.

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* 9. FIT Sports Use drop-in sports to get active and enjoy the camaraderie of your colleagues with FREE Lunch Time Leagues. Drop-in for a game or form a department team if you want!  Either way, it's easy . . . just show up at the gym with your UCLA ID and play! We apologize in advance for times when fields or courts are unavailable due to weather or maintenance.

On average, how many Fit Zone classes do you plan on attending each week?

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* 10. On average, how many Fit Zone classes do you plan on attending each week?

How long have you been attending Fitzone Classes?

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* 11. How long have you been attending Fitzone Classes?

How have Fitzone classes impacted your life?

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* 12. How have Fitzone classes impacted your life?

Comments/Suggestions:

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* 13. Comments/Suggestions:

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