WACOG

PERSONAL INFORMATION:

First Name: (Required)

Last Name: (Required)

Email Address: (Check your email, including spam folders within the next 24hrs for the registration email. (Required)

Phone: (Required)

What type of participant are you? (Required)
—Please choose an option—Employee of WACOGFriend or family member of an employee of WACOG

HEALTH & WELLNESS HISTORY:

Do you meet the CDC's recommendation of 150 minutes of moderate-intensity physical activity per week?
—Please choose an option—YesNo

Do you meet the CDC's recommendation of 2 days of muscle strengthening activity per week?
—Please choose an option—YesNo

What is your health & wellness goal?
—Please choose an option—Lose WeightGain MuscleRemain at my current size

On a scale of 1-10, how important are your health & wellness goals to you?
—Please choose an option—--12345678910

Do you currently participate in any form of physical activity?
—Please choose an option—YesNo

What is the hardest part about performing physical activity for you?
—Please choose an option—Insufficient time to exerciseInconvenience of exerciseLack of self-motivationNon-enjoyment of exerciseBoredom with exerciseLack of confidence in ability to be physically activeCurrently injuredFear of injuryChronic physical or mental disabilityLack of self-management skillsLack of encouragement or support from family & friendsNoneOther

LOOKING FOR ADDITIONAL HELP WITH YOUR GOALS?

Would you like to learn more about our personal training programs? (Pricing as low as $37.50/session)
—Please choose an option—YesNoMaybe Later

Click To Agree Terms And Send Form