Final Step Coaching &Weight Management Program

Registration Form & Release

Thank you for registering for Final Step Weight Management Program. Please complete and submit the short form below (note please fill out all areas).

Answer each statement below. Please check each box to confirm your agreement.

I am ready to take control of my life and get fit.

I promise that I will follow the system and focus on the end result always.

Should you not agree to either statements then you are not ready to get fit.

Full Name

Address

City

State

ZIP

Phone Number

Email Address

How may diets have you tried?

Which session are you registering for?

Form of payment:

Do you take nutritional supplements?

Nutritional Supplements

I agree to complete any additional requirements as needed.

For More Information, Contact us at (314) 259-1177 office (314) 435-9229 cell or e-mail fatt2phat@yahoo.com

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