Fitness Warriors Registration Form

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This form includes a Physical Activity Readiness Questionnaire, the program liability waiver, and questions that help us with our program evaluation. Your name and information will never be shared and is only collected to ensure we have a registration form completed for all class attendees.

Email *

What is your first name (or the first name of the class participant if you are a guardian completing this for a minor)? *

What is your last name (or the last name of the class participant if you are a guardian completing this for a minor)? *

What is your age? *

Please check one or more of the following groups in which you consider yourself to be a member. Please use other if none of these descriptions fit. *

Hispanic or Latino

American Indian or Alaska Native

Asian

Black or African American

Native Hawaiian or Other Pacific Islander

White

Prefer Not To Answer

Other:

Required

I prefer to identify as:

Male

Female

Non-binary

Prefer not to answer

Clear selection

What is your height (in Ft' and Inches") *

What is your weight in pounds? *

What is your zip code? *

What is the name and phone number of your emergency contact? *

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