Registration & Fees
Online Registration
Registration
All Fields noted with a (
*
) are Required!
Name
*
:
Email Address
*
:
Home address
*
:
City
*
:
State
*
:
Zip
*
:
Home Phone
*
:
Work Phone:
Mobile Phone:
Birth Date
*
:
In case of emergency, please contact:
Name
*
:
Phone
*
:
Do you have your doctor’s approval to exercise?
*
Yes
No
What is the present state of your general health?
*
Poor
Fair
Good
Very Good
Please rate your general level of physical fitness:
*
Poor
Fair
Good
Very Good
I am participating in the workout at:
*
6:30 AM - 7:15 AM | Monday, Wednesday, & Friday
7:30 AM - 8:15 AM | Monday, Wednesday, & Friday
How did you learn about Workout on the Hill?
New Bernal Journal
Craig's List
Flyer
Personal referral (whom shall I thank?)
Other
Payment
*
I am registering with a check or cash. I will bring payment to my first workout
I am registering with PayPal
