Please fill out the Registration below and complete the Medical History Questionnaire, Membership Application and Liability Release Form, and Fast Start Assessment Form. Once we have received your Registration, Medical History Questionnaire, Membership Application, Liability Release Form, Fast Start Assessment Form, and boot camp payment, we will send you a confirmation email with instructions for setting up your pre-camp evaluation. All credit card payments are subject to administrative fees.

Medical History Questionnaire

Membership Application

Liability Release Form

Fast Start Assessment Form

 JOIN NOW PRODUCTS PAGE

* Required fields
Name *
E-mail Address *
First Name *
Last Name *
Address *
Address 2 *
City *
State *
Zip Code *
Home Phone *
Cell Phone *
Work Phone
Do you work out? *	yes no
If so, do you like to work out at *	home gym both
How many days per week do you work out or would like to work out? *	1 3 5 or more
My fitness goals are: *	Muscle Fitness Weight Loss Toning
On a scale of 1-10, what is your level of desire to live healthier and longer ______. 10 being the highest and 1 being the lowest *	1 2 3 4 5 6 7 8 9 10
If we had a program for you to accomplish your fitness goal with a 30-day money back guarantee, would you like to know about it? *	yes no
If you could get paid $1,000-$2,000/mo. for becoming more fit, would you like to know about it? *	yes no
Special Comments

I have read and agree to the Privacy Policy *

Spam prevention

Please enter the code shown above and click the 'Submit Form' button. This additional step is required to help protect against message spam.

Enter code above:

Medical History Questionnaire

Membership Application

Liability Release Form

Fast Start Assessment Form

 JOIN NOW PRODUCTS PAGE

Return to Home

Contact:          The Freedom Coach

email:               freedombyfitness@gmail.com

phone:             708-704-7309, 708-596-8728

 fax:                  708-596-8720