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21 Day Jump Start Program

NEW MEMBER INTAKE FORM

Please Complete This Form A Few Days Prior to Coming In for Your 1st Class….


Please Read and Submit Form Below to Activate Your 21-Day Jump Start Program and Schedule Your 1st Class…

  • Please arrive 10-15min early to your first class to meet with your coach for a short class preview. (first class only, a few minutes early to each class thereafter).
  • You must sign in for each class you attend. To do so simply come in for class and there are i pads at the front desk where you can sign in before class.
  • Your coach will help you get started and make sure you are doing what’s right for your goals & ability.
  • Be sure to dress in comfortable and non-restrictive workout clothes.
    (Shorts, tee/tank and sneaks, dress in layers in colder months)
  • Eat a healthy snack 30-60mins before class… (i.e. banana and 1 TBSP PNB)
  • Please read our Medical/Liability Waiver in advance to completing the short form below.
  • Once completed your information will be forwarded to our coaching team so we can be better prepared for your time with us at EXP.

Your EXP Coaching Team!


Full Name (required)

Valid Email (required)

Your Phone (required)

What is your date of birth? (MM/DD/YY) (required)

How did you hear about us? (required)

When would you like to Start Your 21-Day Challenge? (i.e. Mon, May 26) (required)

What class time would you like to attend for your 1st class? (required)

Check if you have read our Medical Waiver, Informed Consent and Release of Liability form above and agree to all terms and conditions contained therein? (required)

What is your #1 goal for signing up for this Challenge? (The 1 thing that if you achieved over the next 21 days you would be thrilled!)

Please tell us about your health and fitness goals, exercise history or share any health issues, medical concerns or past/resent injuries?

Do you have any questions or is there anything else you'd like us to know before class?

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