Add your info
First and Last name*
Today's date*
Mobile number*
Email address*
What zip code do you reside in?*
If you are an entrepreneur, where is your business located?*
Adair Park
Capitol View
Capitol View Manor
East Point
Mechanicsville
Oakland
Pittsburgh
Summerville
West End
Westview
Other
I do not have a business
What neighborhood do you live in?
Adair Park
Capitol View
Capitol View Manor
East Point
Mechanicsville
Oakland
Pittsburgh
Summerhill
West End
Westview
Other
Do you live or work within 1 mile of the Atlanta Beltline?
Yes
No
What is your household status and do you have children or pets?
Single
Spouse/Partner
Widow
Child(ren)
Pet(s)
How did you learn about Fit23 Wellness Program?*
Which areas of wellness are important to you?
Emotional
Environmental
Financial
Intellectual
Occupational
Physical
Social
Spiritual
What are you looking to achieve from the Fit23 Program?*
Stay Active/Reactive Physically
Decrease Body Fat
Financial Independence
Group Mental Health Therapy
Increase Endurance /Stamina
Increase Mobility
Manage Chronic Conditions
Manage Stress
Nutritional Guidance /Programming
Peace of Mind/Emotions
Spiritual Wellness
Social Anxieties
Not sure
Have you worked out consistently in the past year?
Yes
No
How physically active is your job?
Active
Seated
Which fitness classes would you be interested in participating in?
Baseball/Softball
Basketball
Bootcamp Training
Boxing
CrossFit
Court Sports (Pickleball, badminton, cornhole, etc.)
Dance (Hip Hop, Zumba,Chair,Modern,African)
Field Sports (Shot Put,Javelin,High,Long & Triple Jump)
Field Hockey
Football
Hiking / Mountain Climbing
HIIT Training
Jogging / Running
Lacrosse
Martial Arts Training (Karate,Jujitsu,Grapple)
Soccer
Speed /Power Walking
Step Class
Cycling Class (Indoor and Outdoor)
Plyometrics
Pole Dancing
Track Training (100,200,400,hurdles)
Volleyball
Weight Training
Wrestling
Yoga / Tai Chi / Pilates
Other