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First Name:
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Last Name:
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Year of Birth:
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Phone Number:
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E-mail Address:
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Cell Number:
Street Address:
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Address Line 2:
City:
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Postal Code:
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Desired Package:
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Package A: 8 classes – Only Mondays at 6:30 pm - $59
Package B: 8 classes – Only Wednesdays at 6:30 pm - $59
Package C: 8 classes – Only Saturdays at 8:30 am - $59
Package D: 16 classes – Mondays and Wednesdays - $99
Package E: 16 classes – Monday and Saturdays - $99
Package F: 16 classes – Wednesdays and Saturdays - $99
Package G: 24 classes – Mondays, Wednesdays, and Saturdays - $139
Payment Method Requested:
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How did you hear about this program (If from a current or former client, please list their name)?
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Comments / Questions:
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Lean Body Fat Loss Training Registration
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