Fit Camp Registration

Please Read and Fill-in the blanks, Check Each Box to Proceed to the Next Page

First Name

Last Name

Email

Phone Number

How did you hear about us?

Flyer

Personal Invitation

Referral

Facebook/Instagram

Invited by (Name of Wellness Coach)

Have you ever sampled a smoothie and tea from our smoothie bar?

Yes

No

REFERRAL POINTS. Who do you know that: 1) Wants to lose weight, improve their health & nutrition. 2) Would enjoy a free shake & tea service 3) Wants a free Body Scan Analysis and Wellness Evaluation. **Please provide their name (s) & number(s) here.**