First name Last name Email Phone Are you a member of Habit Health? Select... No Yes Are you 16 years old or over? Select... No Yes What day(s) would you be available for a training session? Monday Tuesday Wednesday Thursday Friday Saturday Sunday What timeslot(s) do you prefer? 6am-9am 9am-12pm 12pm-3pm 3pm-6pm 6pm-9pm What length of time would you like your personal training sessions to last? 30 mins 45 mins 60 mins One off or recurring? One off Recurring Not sure How many times a week would you like to train? Once a week Twice a week Three times a week Four times a week More Where would you like to train with a personal trainer? Select... Johnston StEvans BayMajestic What are you wanting to get our of your PT session(s)?

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