Gym Challenge Registration Form

Personal Details

Full Name: *

Date of Birth: *

Age: *

Contact Number: *

Email: *

Challenge

Challenge you wish to register for: *

Start date: *

End date: *

Duration: *

Current Statistics

Body Mass (kg): *

Height (metres): *

BMI:

Category:

Goals

Goal weight: *

What do you hope to achieve in / learn from this challenge? *

Consent

By my electronic signature below, I take full responsibility for my voluntary participation in the challenge being offered by The Gym. I agree to work at my own capacity in the challenge. I release the instructor and The Gym from liability resulting from any injury or discomfort from my participation.

Signature: *

Tap or click on the signature above to sign