BBM From the Couch Registration Question Title * 1. What is your full name? OK Question Title * 2. What is your age? 18-24 25-34 35-44 45-54 55+ Other (please specify) OK Question Title * 3. Are you willing and able to commit to 3x BBM From the Couch Training Sessions per week over the next 6 weeks? (Monday, Wednesday and Friday 11:00am to 11:30am) Yes No OK Question Title * 4. Current Physical Activity - How Many times per week do you exercise? 1-2 days per week 2-4 days per week 5+ days per week No to little exercise OK Question Title * 5. Have you had/do you have any of the following conditions Respiratory (Asthma) High Blood Pressure Stroke Blood disorder Epilepsy or Seizures Diabetes Arthritis Pregnancy in the last 12 months None of the above Other (please specify) OK Question Title * 6. Have you had any major surgery or have been hospitalised in the last 12 months Yes No OK Question Title * 7. Do you have any pre-existing injuries or health conditions that may affect your ability to participate in this program? Yes No OK Question Title * 8. Will you be able to commit yourself to the nutrition guidelines? I.E No takeaways, no alcohol etc Yes No OK Question Title * 9. What will you do to ensure you stay consistent throughout this 6 week programme? OK Question Title * 10. Do you agree to being filmed and/or photographed for the purpose of promoting and inspiring others to join our Free BBM programmes? Yes No OK DONE