EmailMe Form - Sports and Fitness Models

www.SportsModels.com.au

EmailMeForm

Your Name *
First Last
Your Age *
Date of Birth *
DD / MM / YYYY
For our records only.
You must be 16+ to use this form.
Minors will need guardian consent.
Address *

Street Address Address Line 2 City State / Province / Region Postal / Zip Code Country / Region
Email *
For our records only

Please confirm email
Phone *
For our records only
How did you find out about the Sports Model Australian Team? *
Occupation *
Your Experience
Just a few questions in regards to any experience that you may or may not have had.
Please fill in as much as you can, and please make any comments, or ask me any questions.
Have you competed in a Pageant or as as a Sports or Fitness Model before?
Yes
No
If Yes, with whom?
Which category, and when?
How did you go?
Tell me about your experience, and what you liked and didn't like.
If No, tell me what interests you now in regard to becoming part of Sports Models Australia Team
Have you got other stage experience?
As a dancer, gymnast or something else?

Here, you can share with me anything you like.
Health and Fitness
Please be as honest as you can.
I understand that not everybody comes from a back ground of healthy living and exercise. I am here to help change that.
Do you currently exercise?
Yes
No
If Yes, please tell me about your program.

If No, please tell me why.
Tell me about your eating habits
Overall, how would you describe your health and fitness levels?

Where do you feel you need to improve?
Your Body
This is what we are here for :-)
What is your best body part?
What is your worst body part?
Your height
Your current weight
Your preferred weight
Body fat percentage if known
Have you got a photo you can upload of yourself?
Have you got a photo of what you would like to see yourself as you can upload?
Before Submitting;
If there is anything else you would like to tell me about you, your goals or questions?
Is there any reason that you can not train?
Do you have any injuries, current or pre-exisiting? Please use this space to explain
I have read and understand that by submitting this form I am under no obligation to train, compete or continue with any program.
I understand results may vary between individuals and success is dependent on my commitment and dedication.
I have accurately declared all injuries, movement limitations, and medical conditions and am in a fit state to exercise.
I am fit to follow a healthy eating plan.
I understand that a further assessment will be required prior to commencement. *
I agree

Melody Carstairs | South Yarra Fitness | 337 Toorak Rd South Yarra 3141 Vic AUST | +61 3 9015 7546 | +61 433 393 333

Your Experience

Health and Fitness

Your Body

Before Submitting;