Outdoor/Online Private Group Fitness registration form
Please fill in the form below to register for your Outdoor/Online Private Group Fitness.
*mandatory fields.
About me
First Name
*
This field is required
Last Name
*
This field is required
I am a PURE Cardholder
*
Yes
No
This field is required
Cardholder Number
*
This field is required
Mobile number
*
This field is required
Email
*
This field is required
About the participants
Please disclose any injuries and/or any medical or physical conditions that may prevent participants from engaging in physical exercise
*
This field is required
Are any of the participants pregnant?
*
Yes
No
N\A
This field is required
How many weeks into the pregnancy?
*
This field is required
Action plan
What is the primary interest or collective goal of the participants taking this Online Private Group Fitness class?
*
This field is required
What is the preferred schedule for this Online Private Group Fitness? You can choose more than one option.
*
Morning
Lunchtime
Afternoon
Evening
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
This field is required
What are the preferred time slots? Please indicate your preference. You can choose more than one option.
*
6am-9am
9am-12pm
12pm-2pm
2pm-6pm
6pm-9pm
This field is required
Which gender would you prefer for your PURE Fitness instructor?
*
Male
Female
No preference
This field is required
Any other important information you would like to provide for your Online Private Group Fitness?
*
This field is required
If you already have a preferred teacher, please let us know their name. Otherwise, we will find a suitable teacher based on your provided information. Please note that not all PURE Group Fitness instructors are available for Online Private Group Fitness.
*
This field is required
Submit