Life Center Fitness - The Life Center Fitness

Please fill out the following form and submit it. We will get in touch with you.

Please Select How You Want To Pay*

$85 Per Session / Twice Per week

$640 Per Month / Twice Per Week

$900 Per Month / 3 Times Per Week

First Name

Last Name

Address 1

Address 2

City

State

Zip Code

Confirm Email

Cell Phone

Home Phone

Height (cm)

Weight (kg)

Age

Do you have any issues with your shoulders, back, knees or hips?*

Do you have high or low blood pressure or any other issue we need to know about?*

Asthma?*

Diabetes?

Have you had joint problems or injuries in the past?

What are your fitness goals?

Goal weight?