North Shore Weight Loss Charity Challenge

Registration

* First Name
* Last Name
* City
* Province
Postal Code
* Home Phone
Fax
Cell
* Email
* Gender
Shirt Size
Emergency Contact Name
Emergency Contact Phone Number
Registering as a coporate team?	Yes No
Number of people being registered
Company Name
Current Fitness Level
How did you hear about the challenge?

Steps In Registering For The Weight Loss Challenge Fill out the information requested and submit this form or download a pdf version of this form and fax to 604-929-SOUL. Click here for dates, times and program information. To pay you may use: Paypal which offers debit, MasterCard or Visa options or Drop off a cheque to the Soul Fitness Studio No mail in registration. All participants must fill out an intake and par-Q form on the 1st day. Soul Fitness recommends all participants receive medical clearance before starting an exercise program. Click here to download your pledge sheet. All pledges will be donated to The Heart & Stroke Foundation. No refund within 30 days of program start date.
* By clicking on the submit button below, I agree to the above terms.