OLYMPIA FITNESS PLANET


Name

Father's Name
Address

City

Phone No

Age

Marital Status : Single / Married

Have you been here before?Yes/No
Company/Sport
Email
Zip
Mobile
Male/Female
Do you have any children? Yes/No
Are you currently involved in an excercise program? Yes/No

WHAT ARE YOUR FITNESS GOALS? CHECK ALL THAT APPLY
	Lose Weight - How Much
	Gain Weight - How Much
	Cardiovascular conditioning
	Tone and Firm
	Increase muscular strenght/size
	Stress management
	Other

HOW LONG HAVE YOU BEEN THINKING ABOUT ACHIEVING YOUR GOALS? 1MTH 3MTHS 6MTHS ONE YEAR OR MORE

WAIVER
I accept responsibility for my use of any and all apparatus, appliances, facility, priviledge or service whatsoever, owned and operated at this club at my own risk, and I shall not hold this club, its shareholders, directors, officers, employers representatives and agents harmless from any and all loss, claim, injury, damage, or liability sustained or incurred by me resulting therefrom.


	Fitness Planet
	Facilities
	Pre Registration
	Rules & Regulations
	Franchise
Address : Admn. Off : 1798/1, Maharaj Nagar, Near P.A.U. Gate No. 3, Ludhiana.