Getting to know you – Zahar Fitness

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Tell me about your self

Name *

Birth Date *

Month *

Day *

Year *

Email Address *

Gender (Optional)

Height *

Occupation *

Primary Goals *

Physical Training Experience *

Are you on any medication? *

Do you take supplements of any kind? *

Do you have joint problems that are aggravated by exercise? *

Any previous injury or surgeries? *

Emergency Contact Person

Relationship *

Phone *

Additional Information

Date signed *

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