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Caribbean Sounds 5K Walk 10K Race

Personal Information:

First Name

Last Name

Email Address

Date of Birth

City/State of Residence

Phone Number:

Best time to reach me:

How did you hear about us?

Event Interests (Check as many as apply):

Fitness Retreats
Jumpstart Series
Fitness Parties
Personal Training
Running Camps
Smoothie Mixer
Fitness Seminar
Weekly Running Session

Previous Athletic History:

How many times per week do you work out?	1 2 3 4 5+
How many days of weight training?	1 2 3 4 5+
How many times do you have a meal?	1 2 3 4 5+
How many glasses of water per day?	1 2 3 4 5+
How often do you snack between meals?	1 2 3 4 5+
Do you take a vitamin supplement?	Yes No
Do you have any health conditions which may require special attention or a customized fitness program? Yes No
If yes, please describe:
What are your fitness goals?

Do you have a special upcoming event in which you want to obtain a certain weight and/or health level? Yes No
If yes, please describe:

If you are single and prefer dating someone who has similar fitness goals, are you interested in the fitness speed dating events? Yes No

Note: Please contact your physicians before participating in any fitness event.

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