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TEXINS CHALLENGE - 6 Week Fitness Performance Program 2019
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1.
First Name:
(Required.)
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2.
Last Name:
(Required.)
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3.
Email Address
(Required.)
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4.
Are you currently a TI employee?
(Required.)
Yes
No
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5.
Are you a Texins Member?
(Required.)
Yes
No, but would like to join for this program
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6.
Program Cost: $60 Texins Member; $170 Non- Member. Please select your payment option.
(Required.)
$60 Texins Member, Payroll deduction (TI employees only).By selecting this option you are authorizing Texins to proceed with the $60 payroll deduction charge.
$60 Texins Member, Credit Card. Please provide credit payment at the front desk at Texins Fitness Center by Tuesday July 9th
$170 Non Texins Member, Payroll deduction (TI employees only). By selecting this option you are authorizing Texins to proceed with the $170 payroll deduction charge.
$170 Non Texins Member, Credit Card. Please provide credit payment at the front desk at Texins Fitness Center by Tuesday July 9th
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7.
Commitment is Key! The results you can expect from this program will reflect your commitment to the program.
I will ensure that I will carry out the full program by attending both classes for the full six weeks. (Please sign below)
(Required.)
Thank you for participating in the 2019 Texins Challenge!
