FREE GUEST PASS!!

Sign up for a FREE one day pass at any of our National Fitness & Tan locations.

Please provide the following contact information:

*Name
*Street Address
Address (cont.)
*City
*State/Province
*Zip/Postal Code
*Home Phone
Work Phone
*E-mail

Do you currently workout?

Yes No

What are your fitness goals?

Select any of the following options that apply:

Lose Weight
Tone and Firm
Medical Condition
Cardiovascular Conditioning
Increase Muscle and Build Strength
Stress Management
Injury/Rehabilitation

How did you hear about us?

Referred By Website Drive By Flyer Newspaper Direct Mail Radio Other

If referred by or other, please specify

How long have you been thinking about reaching your goal?

1 month, 3 month, 6 months, Year or more?

On a scale from 1 to 10. (10 being the most serious) How serious are you about accomplishing your goals?

1 2 3 4 5 6 7 8 9 10