Enrollment Form - Starts January 2018 

Starts January 2018 - Once you complete this form, we will quickly review your enrollment. We will set-up your account and reach out to you. If you are referring a friend or family member to receive our one time 25% special discount for our New Year Special, be sure to put their name in the space provided below so we can link both accounts. Remember, the special is only for one month. However, after the first month is over we will still give you a different special discount :) For your first month, we will only be required to be put on a recurring draft for 4 weeks. After that, YOU CAN ORDER WHENEVER which includes your set discount :D Pausing is allowed during your locked in first month only up to one week. Ending before completing your first month will result in collecting our big discount we gave you. Though we do not believe in applying cancellation fees, we can credit your account to be used whenever you please.

Your are getting closer to living a healthier life style!

 

Please complete the form below

Name *
Name
We will link both accounts so be sure to spell his or her name correctly
Address *
Address
Phone *
Phone
Fitness and Health Survey
Fitness and Health Survey
I work out and do physical activies a lot
I move around on my feet most of the time at work
I eat healthy most of the time