Welcome to Betty's Box BC

We are so glad you are here! Please take a few minutes to fill out this form so we can get to know you a little more and one of our coaches will be in touch with you shortly.

First name

Last name

Email

Phone

Birthday

Month

Day

Year

Emergency Contact Name

Emergency Contact Phone Number

Do you have a short term fitness goal? (3 months)

Do you have a long term fitness goal? (1 year+)

How would you describe your current fitness level?

Beginner

Intermediate

Advanced

How would you describe your current fitness level?

Beginner

Intermediate

Advanced

Have you participated in any of the following before?

Group Fitness

Crossfit

Weightlifting

Other

What did you like or dislike about your previous fitness routine?

(optional)

Do you currently follow an exercise or training routine?

If yes, please describe

Are you comfortable learning new movements, such as Olympic lifting, gymnastics-inspired exercises, or cardio-focused movements?

Yes

No

I'm not sure

Do you have any current injuries, pain, or physical limitations we should know about?

If yes, please describe

Have you had any previous injuries, surgeries, or conditions that might impact your ability to exercise safely?

Examples: Joint issues, back problems, heart conditions, etc.

Do you have any medical conditions or concerns that could influence your ability to exercise?

Examples: asthma, diabetes, high blood pressure, etc.

Do you have any medical conditions or concerns that could influence your ability to exercise?

Examples: asthma, diabetes, high blood pressure, etc.

Are you currently under a healthcare provider’s care for any reason?

If yes, please explain briefly

Do you take any medications that might affect your exercise?

Example: heart medication, blood pressure medication, pain relievers

How would you describe your daily energy level?

Consistently high

Moderate

Often fatigued

Do you have any mobility limitations, such as trouble squatting, lifting overhead, or getting up from the floor?

Yes

No

How much sleep do you get per night?

Do you follow any specific nutrition plan or dietary restrictions?

What motivates you to stay consistent with fitness?

Examples: Health, family, personal growth, competition, enjoyment, community

How can we best support you on your fitness journey?

Examples: Extra coaching, accountability, goal setting, personalized tips, etc.

What are you most excited about as you begin your journey with Betty’s Box BC?

How did you hear about us?

Do you have any other information, thoughts, or concerns you’d like to share with us?