motivFIT - Fitness Motivation With Results

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Register for Agoura, Oak Park, Westlake Boot Camps

 

COMPLETE THE FOLLOWING REGISTRATION FORM TO ENROLL IN MOTIVFIT CLASSES & START YOUR FREE TRIAL

Note: Your FREE TRIAL will give you the opportunity to come try a motivFIT Workout for FREE and see if our program is for you. Upon completing your FREE TRIAL and you decide to stay on board, we will email you a website link directed to motivFIT's secure server, so that you can complete the financial portion of your enrollment for the Body Blast Challenge.  We do not accept checks or cash.  

**GROUPON AND LIVING SOCIAL CUSTOMERS DO NOT RECEIVE A FREE TRIAL**


 
AGOURA HILLS  View Class Schedule & Availability 
5:30 - 6:30 AM  
8:30 - 9:30 AM 
6:00 - 7:00 PM  

I HAVE RECEIVED ONE OF THE FOLLOWING DISCOUNTS


Groupon     Enter coupon code:
Living Social     Enter coupon code:
 

 

motivFIT Gift Card
Note: You must present your Gift Card to your Fitness Coach at your first workout.  This card is redeemable for the Body Blast Challenge at all motivFIT Locations.  Gift card may not be combined with other promotions.  May be used by first-time clients only.  Sorry, not exchangeable for cash.

Corporate Rate         Please enter code:


Special introductory offer from Marketing Material

Enter code:    Enter source:

 

 

COMPLETE YOUR PERSONAL INFORMATION 


First Name:

Last Name

Street Address:

City
Email Address: 
State             Zip 
    
Home Phone:     
Work Phone
Cell Phone:  
Profession
Date of Birth:  
My main goal is:

EMERGENCY CONTACT INFORMATION

*Name:     

*Phone: 

 

MEDICAL HISTORY

*1. Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?
    

*2. Do you feel pain in your chest when you perform physical activity? 
      

*3. In the past month, have you had chest pain when you are not performing any physical activity?
      

*4. Do you lose your balance because of dizziness or do you ever lose consciousness?
      

*      

*      

*       

 
If you have answered " Yes" to one or more of  the above questions, consult your 
physician before engaging in physical activity.  Tell your physician which questions 
you answered "Yes" to.  After a medical evaluation, seek advice from your physician 
on what type of activity is suitable for your current condition.

 

*8. Do you have asthma? 

      

*9. Do you have High Blood Pressure?

      

*10. Have you ever been diagnosed with Diabetes?

    

*11. Have you ever been diagnosed with epilepsy or have a seizure disorder?

      

*12. Do you take any prescribed medications?

    

  If Yes, List Meds:       

*13. Are you allergic to any medications?

       
  If Yes, List Meds:

*14. Have you ever had any major injuries?

     No   
  If Yes, Describe:

*15. Have you had a broken bones or fractures ?  If so, how long ago?

     No   
  If Yes, Describe:

*16. Do you have any pains in your neck or back pain?

     No   
 If Yes, Describe:

*17. Have you had any knee pain or injuries in the last 5 years?

     No   
 If Yes, Describe:

*18. What are your goals for the next six months?

How did you find us?

Please specify publication / website / friend or other referral:


PARTICIPATION AGREEMENT; INFORMED CONSENT WAIVER; LIABILITY RELEASE; 
& NON COMPETE AGREEMENT

I Accept The Above Terms and Conditions       

 

 

motivFIT™, the motivFIT ™ logo and Fitness Motivation With Results™, Body Blast Challenge™,  are trademarks of motivFIT
Website
www.motivFIT.com.  Copyright © 2009 Fitness Training For Life, LLC

 

motivFIT is proudly serving the following communities:

Westlake Village   Thousand Oaks   -   Agoura Hills   -    Newbury Park   -   Oak Park   -   Lost Hills   -    Lake Sherwood   -   Old Agoura   

  North Ranch   -    Dos Vientos Ranch   -   Sunset Hills   -   Calabasas   -  Camarillo   -   Simi Valley   Moorpark - Conejo Valley 

 

Westlake Village Boot Camps
Outdoor Fitness Boot Camps classes that guarantee results of losing weight, body fat and inches. Westlake Village Boot Camp is a certified fitness camp training program in Westlake Village and is locally owned and operated.  We proudly serve Westlake Village,  Lake Sherwood, North Ranch and surrounding areas of the Conejo Valley and Ventura County.

Thousand Oaks Boot Camps
Outdoor Fitness Boot Camps classes that guarantee results of losing weight, body fat and inches. Thousand Oaks Boot Camp is a certified fitness camp training program in Thousand Oaks Ca, and is locally owned and operated.  We proudly serve Thousand Oaks, Newbury Park, , Dos Vientos Ranch, Sunset Hills, Moorpark, Simi Valley and surrounding areas of the Conejo Valley and Ventura County.

Agoura Hills Boot Camps
Outdoor Fitness Boot Camps classes that guarantee results of losing weight, body fat and inches.  Agoura Hills Boot Camp is a certified fitness camp training program in Agoura Hills Ca, and is locally owned and operated.  We proudly serve Agoura Hills, Lost Hills, Old Agoura, Oak Park, Malibu, Calabasas and surrounding areas of the Conejo Valley and Los Angeles County.