Registration Form

Online Fit Team Registration and Waiver

Fees:
$225 Training fee
$50 one time membership fee
$10 shipping *only if you need your equipment & shirt mailed
*payment option available, contact us to get started. (email or 916-690-7624)
Fees include: Weekly accountability checkins, private Facebook group for team support and communication and three 30 minute workouts (2 via online video) every week. New member fee includes our custom Keep Moving Mama tech team shirt and a one on one needs assessment.

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

1. What are your goals for this season? Fitness, health, lifestyle, specific distance or time, etc… *

2. What are your long term goals for fitness, health and/or lifestyle? *

3. What is your fitness background? What do you currently do for exercise? *

4. How did you hear about Keep Moving Mama? If it’s a friend, include her name so we can thank her. *

5. What do you hope to gain by joining? *

6. How many servings of fruits & vegetables do you eat each day? *

7. How many ounces of water? *

8. Anything else your trainer should know? *

Click here to read waiver. Once you are done, click the BACK button on your browser to return to this form.

I have read and agree to the waiver above. *

I agree

Submit

​Online Fit Team Registration and Waiver

Click here to complete your first progress report.

Online Fit Team Registration and Waiver