Special Registration Form

Special Registration Form

Please fill out the registration below. Once we have received your registration, we will send you a confirmation email with instructions for setting up your evaluation.

* Required fields
Name *
E-mail Address *
First Name *
Last Name *
Address *
Address 2 *
City *
State *
Zip Code *
Home Phone *
Cell Phone *
Work Phone *
I rate my current fitness level at a _______. 10 being the highest and 1 being the lowest. *
My fitness goal in this camp is *
How did you hear about this fitness camp? *
If by referral, who can we thank? *
I have read and agree to the Privacy Policy *

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Contact: The Freedom Coach

email: freedombyfitness@gmail.com

phone: 708-704-7309, 708-596-8728

fax: 708-596-8720