Embed
Email

WLC Aug 09 - Registration Forms

Document Sample
WLC Aug 09 - Registration Forms
Weight Loss &

Body Shape Challenge

2009 Entry Information - August

 

 



 





There are many people who have stood exactly where you stand right now. Something has made you stop

to take a look at yourself and say “I can be better – there is a lot more I can achieve”.

Do you feel as though you aren’t as fit as you used to be? Are you sick and tired of being sick and tired?

Have you thought about how you would like to look, how you would like others to see you, and most

importantly – HAVE YOU THOUGHT ABOUT HOW YOU FEEL? You know that NOW is the time to take

control of your own life.

We want you to know that by participating in the Fresh Start Weight Loss and Body Shape Challenge you

are not only challenging other people, you are also challenging yourself. The only thing standing in the way

of changing your life for the better, is YOU.

You may have a long way to go to achieving your goal, or you may have just a small change you want in

your life. Whatever goal you set for yourself, you should know that during the course of the challenge no

matter how difficult the challenge seems, you should not feel alone. We are here to help you with lots of

information and professional resources. By focusing on the 3 key areas of your life – Diet, Exercise and

Goal Setting – you will overcome what you once thought was difficult, and be on your way to success.

By participating in the 12 week Challenge, you are making an investment in your future. We want it to be

worth the challenge. Whether you come in 1st place or not, it does not matter. By participating in this

Challenge and following the program outline we help set for you, you will finish a winner at the end of the

day. No matter where you stand right now, 12 weeks from the day you begin, you will see a better you.

Best of Luck

The Fresh Start Team

Information 



How do I enter? How long does the challenge go for?

Each participant will enter at Fresh Start reception by filling out the The challenge runs for 12 weeks. The start date and finish date are

following Entry Form. final and they must be adhered to.



How is the challenge judged? Do I have to be a member of Fresh Start to participate?

Each participant will be judged based on No. However, if you are a member you save money on the cost of the

• change in body shape* challenge and you must come to Fresh Start to have your initial,

middle and final weigh ins, your weekly sessions as well as have your

• change in body measurements

final photo taken by our staff. If you are a member you will have the

• weight loss/gain advantage of using our state of the art equipment and have access to

• attendance to the information and training sessions our staff for all those questions you may have week to week.

• amount of visits to the gym (if a member) Weekly information and training sessions

• overall performance and effort in keeping a daily diary So you don’t know much about nutrition and exercise, or you are

* This is done by “Before and After” photos and recordings of body unsure of how to get the edge on your training - that’s ok, this is going

measurements and weight. The recordings are to be done by Fresh to be a new learning curve for you. By attending the weekly

Start Staff and will remain private and confidential. The “Before” information and group fitness training sessions you will gain a better

photos may be taken at home. The “After” photo must be taken by understanding of how to achieve your goals in a healthy and safe way.

Fresh Start on Fresh Start premises. Requirements for “Before” If you feel you require more help, we urge you to speak to Meredith

photos are below. Julliard - our Challenge Co-ordinator and she will ensure that you get

the help you require.

How do I take my “Before” photo?

At the end of the challenge, you will have in your diary 2 x “Before” What are the information and training sessions?

photos and 2 x “After” photos. Once a week there will be an information and training session. This is

a time for everyone to get together to go through their diaries and ask

To take your own “Before” photos, please ensure you do the

the trainer questions about their training and nutrition. After the

following:

information session participants will then do a half hour weights/group

• Take one front-on and one side-on based training session with a trainer. This way, everyone will get to

• Please hold a newspaper with the date clearly visible on it to prove know each other and have the chance to train with the other

your start date participants. There will be a daytime session and an evening session

• Wear similar clothes in both “Before and After” photos. If possible, giving everyone a chance to participate.

ladies wear a bikini or crop top and undies, and men wear just Are the information and training sessions compulsory?

boxers, swimmers or undies. This is to optimise your chances of Yes! If you are going to participate in the Challenge, it is compulsory to

showing the judges the body transformation attend each information and training session. After all, this 12 weeks is

• Make sure you let-it-all-go, you want your photos to be as realistic all about you!

as possible, so stand relaxed and don’t suck it all in

Will Fresh Start be running this program regularly?

• Make sure you photograph from at least the knees up Yes! You may enter into as many rounds as you like. When you have

• Make sure you take your photo with a white or plain background achieved your goals for this round, why not re-enter and take the

• If this is all too hard, book your photo session with Fresh Start, and challenge again or register for the Ultimate Body Challenge. This will

we’ll take care of it for you. Call reception on 9970 8400. keep you motivated on your path to success.



Who is the challenge judged by? Do I have to record all my measurements and have my photos

Our panel of Judges includes: taken?

Yes! These results will help the judges decide a winner. Also it is a

1. Scott Flint - Head Personal Trainer and Director of Fresh Start

motivating factor in helping you achieve your results.

2. Rebecca Mountford - Fresh Start Director

3. Meredith Julliard - Weight Loss Challenge Co-ordinator If I have any more questions who do I contact?

You can call Fresh Start on 9970 8400 and speak to our friendly staff.

Package Info – August Start. 

Entry into the Challenge includes the following: Important Dates to Remember

• Before and after photos • 26th Aug 2009 – Final sign up day

• Certificate of achievement • 29th Aug 2009 – First weigh-in and training day

• 3 scheduled weigh-ins and measure-ups • 18th October 2009 – Team Challenge

• Food and Exercise Diary. • 21 August 2009 – Final weigh in day

• Weekly information meetings • 28 August 2009 – Weight Loss and Body Shape Challenge Dinner and Drinks

• Weekly training sessions

• Email support

Information and & Training Session Times – please book in at reception

Mondays 11:00am or 7:30pm.

What is the Schedule?



Date Time Description



Weigh in booked prior

th

to 10:30am. Please book your weigh in and photo at reception. These will be done from Tuesday 25 of

th

August through to Friday the 28 of August.

29th August

ARRIVE AT 10:30am The workshop day will run from 10.30am till 2.30pm attendance is compulsory. Lunch

for workshop order can be placed on the day with us.

registration



31st August 11am or 7.30pm Week 1 – Know your Allies and Enemies Body Weight Training



7th September 11am or 7.30pm  Week 2 – Be a smart shopper: Know your labels Balls, Balls and Balls



14th September 11am or 7.30pm  Week 3 – Mixing it up: Getting your body off auto-pilot Blood Shunting Training



21st September 11am or 7.30pm  Week 4 – Posture Switching on the Core



28th September 11am or 7.30pm  Week 5 – Food Matters DVD Interval Training



* 6th October Check session times Week 6 – Plateau Busters Fit Test



Wk Commencing Half way – Weigh-In. Please book your time with Reception, remember to wear

Book in with Mere

5th October the same clothes you wore for your first Weigh-In. (See your photo)



12th October 11am or 7.30pm  Week 7 – Basic Super foods Outdoor Agility Cxt



18th October 11am or 7.30pm  Week 8 – Team Challenge Details TBC



19th October 11am or 7.30pm  Week 8 – Moment to Shine, Moment to Polish Suspension Training



26th October 11am or 7.30pm  Week 9 – Stop Start Continue Tough Man / Woman



2nd November 11am or 7.30pm  Week 10 – Staying focused in the real world Weights Floor Workout



9th November 11am or 7.30pm  Week 11 – Panel of Experts Partner Training



16th November 11am or 7.30pm  Final Session – It’s a wrap Fit Test





Book your weigh in FINAL Weigh-In and Fitness Test. Please book your time with Meredith,

21st November

with Meredith. remember to wear the same clothes you wore for your first Weigh-In.







The presentation awards night will be held on the 28th of November

in conjunction with the Fresh Start Christmas Party

*The sessions will run on the Tuesday, as it is the long weekend.

Rules and Terms 

Thank you for taking the first step towards a healthier lifestyle, with us here at

Privacy Statement and Acknowledgment

Fresh Start Health and Fitness Pty Ltd. We trust you will enjoy your time with

In the course of establishing a Contract with you and during the term of that

us and we hope we can be of as much assistance as possible, in helping you

Contract we will obtain access to certain sections of your personal information

to reach the results you set out to achieve. If at anytime you have any

(such as information concerning your health, financial position as well as

questions, need any help in our facility or would like to bring anything to our

photos obtained during the UBC). We respect the necessity to keep such

attention, please do not hesitate to contact us, as we are as determined in

information private. Fresh Start will keep your private information secure and

helping you achieve your individual fitness goals, as we are to promote health

then only use, disclose or deal with such information for the purpose of your

and fitness though the greater community.

membership and then only in accordance with your prior written permission.



Recommendation: Acknowledgement

We recommend that you consider these terms and conditions before you I acknowledge that I have signed up for a 12 week course of which

agree to begin the Fresh Start Weight Loss and Body Shape Challenge. full payment is required prior to my program beginning unless I have

(WLC). organised a payment plan (see payment plan form).



I will not participate in this challenge in a way that could hurt my

Club Rules:

health and wellbeing. I will not do anything that is unsafe. Fresh Start

Please refer to the Fresh Start Health and Fitness Pty Ltd Terms and

does not take any responsibility for people who take unsafe measures

Conditions for all club conditions rules. This is available on the “Fitness

to lose weight. This includes measures which are either legal or

Centre” page of our website. www.freshstart.com.au

illegal. We recommend that all participants talk to a nutritionist and

Minimum Age: personal trainer as well as a G.P before starting this WLC.

Entrants must be a minimum age of 16 years or older. If entrant is under the I acknowledge that it is important that I read and understand the

age of 18, the entrant must seek a parent or guardian’s written approval to do terms and conditions. I have signed this understanding that I will be

the WLC. bound by the terms and conditions annexed. I warrant that I am not

Release and Indemnity aware of any physical condition which prevents me from engaging in

Damages / Personal Injury - We give you warning that, whilst on our premises

physical exercise or, which poses a risk to other customers, staff and

contractors of Fresh Start Health and Fitness Pty Limited.

you may suffer injuries including but not limited to broken bones, soft tissue injuries

and joint injuries. These injuries may occur as a result of you slipping on wet

flooring, weights striking you, collision with equipment or other members.

Signatures

A. In consideration of the grant of membership (casual or otherwise) to you,

entitling you to engage in fitness activities provided by Fresh Start, you hereby Name: ________________________________________________

release and forever discharge Fresh Start from all actions, suits, proceedings,

claims, demands, losses, damages, penalties, fines, costs, including for

Signed: _______________________________________________

personal injury and expenses however arising that you may have had but for

(Member/Participant)

this release arising from or in connection with your participation in fitness

activities at Fresh Start or being on Fresh Start’s premises.; and Signed: _______________________________________________

(Fresh Start - witness)

B. You indemnify Fresh Start to the extent permitted by law in respect to any

loss or damage (including consequential loss) arising as a result of or in Date: _________________________________________________

connection with your participation in fitness activities provided by the

Company or arising from being on club premises and whether caused or

contributed to, directly or indirectly, by any act of negligence to the fullest Guardian Details if under 18 years

extent permitted by law, breach of duty, default and/or omission on the part of

Name of Guardian: ______________________________________

Fresh Start or otherwise.

Signature: _____________________________________________

Release and indemnity - In consideration of Fresh Start accepting your

application for The Fresh Start WLC, you agree that Fresh Start shall not be Guardian Address: ______________________________________

liable for any loss, damage or theft of any property belonging to, or brought

______________________________________________________

onto any Club premises by you or your guest, occurring on said premises

except where caused by the gross negligence or wilful neglect of Fresh Start. Phone: ________________________________________________

In addition, Fresh Start shall not be liable for any loss or damage arising from Relationship: _________________________________________

the death or, personal injury or illness suffered by you or your guest which

occurs upon any Club premises or as a result of the use of facilities and / or

equipment provided by Fresh Start, except to the extent that such death,

personal injury or illness arises form the gross negligence or wilful neglect of

Fresh Start.

Registration   

Personal Information

(circle) Mr. Mrs. Miss. Ms. Dr. | (circle) Male Female I will pay ■ In full or ■ In installments (see below)



First Name: ____________________________________ Surname: ______________________________________



Address: ______________________________________________________ State: _________ Post Code: _______



Email: ________________________________________________________ Date of birth: ______________________



Ph: ___________________________________________ Mob: __________________________________________



Next of Kin: ____________________________________ Phone: ________________________________________



Date you begin your program_______________________ Date you finish your program _______________________



Starting Weight__________________________________ Goal weight: ____________________________________



1. Are you on any medication (including pill)  Yes or  No

2. Have you been on a diet before  Yes or  No

2b.Did you achieve your weight loss goal  Yes or  No

3. (Please circle if yes) Has your GP ever tested you for insulin resistance, thyroid dysfunction or POS

4. (Please circle) How would you describe your stress levels low – moderate – high – extreme

5. (Please circle) How would you describe your life style sedentary – moderate activity- active- very active

6. Do you have the support of your family and friends  Yes or  No





The cost for First Timers The Cost for Repeat Challengers



Fresh Start Member Non-Member Fresh Start Member Non-Member



Only $350.00 $450.00 $275.00 $375.00





Can I pay in instalments?

We understand that times can be tough and we want everyone to have access to this amazing challenge. If you would prefer to

pay in installments we can arrange this. Please select from one of the options below:



Are you a Fresh Start Member?  Yes or  No



Instalments for First Timers Instalments for Repeat Challengers



Fresh Start Member Non-Member Fresh Start Member Non-Member



2x Instalments of $180 2 x Instalments of $230 2x Instalments of $140 2 x Instalments of $190



Installment agreement: I agree to pay 2 x installments of __________________ on the dates of 29th Aug 2009, and 18 th

October 2009. I understand that the above amount will be debited from my credit card listed below. I understand that if paying in

installments, the price includes a credit card transaction fee. I understand that I am liable for the payments above and should my

card fail I will make payments from another card on the dates listed above by phoning reception on 9970 8400. Fresh Start will

call you if the payment does not go through to arrange other payment. (If you want to pay cash installments, you still must

provide credit card details should you fail to make cash payments by the dates above).





Card type  Visa  MasterCard



Card number ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ / ___ ___ ___ ___ Expiry ___ ___ / ___ ___



Name on card ____________________________________________



Signature ________________________________________________


Related docs
Other docs by ColleenEynon
MRO Conference 2008 - ORDER FORMS.XLS
Views: 4  |  Downloads: 0
Delivery form Delivery form
Views: 42  |  Downloads: 1
Volunteer Sessional Worker Application Form
Views: 2  |  Downloads: 0
Exceptional Circumstances Submission Form
Views: 21  |  Downloads: 1
2008 FINANCIAL INTEREST DISCLOSURE FORM
Views: 3  |  Downloads: 0
By registering with docstoc.com you agree to our
privacy policy

You are almost ready to download!

You are almost ready to download!