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Start Smart - Personal Fitness Program Step 2 - Complete New Client Sign Up Form

Congratulations... I promise you that you are making the best choice by choosing Achieve Fitness to help you achieve your health, fitness, and weight loss goals.

Please complete the fields below and then click submit.

After you complete this form you will be forwarded to our "Health History Profile" which must also be completed before we can start your program.

If you have any questions at all while completing these forms please call us at 1-888-872-7961 or
email us .

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Contact Information
First Name *
Last Name *
Title
Company
Email *
Work Phone
Work Phone Ext
Home Phone *
Mobile Phone
Fax Number
Lead Source
Notes
(mm-dd-yyyy)
Other Information
How did you hear about us?
Billing Address
Street Address 1 *
Street Address 2
City *
State *
Postal Code *
Country
Credit Card Information
Card Type *
Card Number *
Expiration Month *
Expiration Year *
Product Purchase Plan
Jump Start - Personal Fitness Training Program: 3 session introductory packageAmt
1 Payment of $269.00
$269.00
2 Payments of $150.00
$150.00
Process

Cancellation Policy

I understand that session dates and times are scheduled with my trainer and that a 24 hour notice is required when rescheduling or canceling a scheduled session. Failure to provide 24 hour notice will result in the loss of that session. If there are extenuating circumstances, please contact your trainer as soon as possible. The trainer has the right to make exceptions.

Money Back Guarantee

We actually offer two guarantees:

1. 100% Satisfaction

If at any time, you are not satisfied with our service you may stop your program and request a refund for any sessions that you have paid for but have not yet completed.

2. We GUARANTEE Results!

If after completing your program, you haven't achieved the goals set at the start of the program, you are welcome to request a complete refund. In order to be eligible for a full refund you must have completed your program in the specified time, not missed any scheduled sessions, and have followed the fitness and nutrition program outlined for you by your trainer.

Acknowledgement

By completing this form you acknowledge that you have read and understand the terms and conditions of the program and that by submitting this form you give Achieve Fitness Personal Training, inc. your digital signature accepting this agreement.

After completing this form you will be forwarded to another page where you will need to complete our Health History Profile.

I have read and understand the terms of this agreement.
(Enter your initials)