Cliff's Virtual Bodyweight Workout Class Contact InformationName (First, Last)* Email* Phone Number* Date of Birth (DD/MM/YYYY)* Address* QuestionaireAre you currently exercising?YesNoIf yes, how many times per week1234567If yes, what types of exercise? (check those that apply) Resistance Training Running Swimming Biking Hiking Team Sports Other How would you rate your fitness level? 1 Sedentary 2 Somewhat active 3 Active 4 Very Active How would you rate your occupational activity level? 1 Very sedetary 2 Sedentary 3 Somewhat active 4 Very active Have you been referred by friend? If so, Who? PhoneThis field is for validation purposes and should be left unchanged.
