Club Information e-Newsletter Careers
Community Partners
Please complete this short survey and register to win a FREE trial membership!
Do you currently exercise?
1-2 days per week 3-5 days per week 5+ days per week No, I do not currently exercise
What is your age?
18-25 26-35 36-46 47+
Which location is most convenient for you?
East Memphis (6161 Shelby Oaks Drive) Downtown (1 N. Main)
How far do you live from either of our two locations?
1-5 miles 6-10 miles 11-20 miles 21+ miles
Have you ever had certified supervision on a past exercise program?
No Yes
What are your short-term wellness goals?
What are your long-term wellness goals?
Do you have any health concerns? If so, please explain in the box below:
How did you hear about our Website?
Newspaper Television Magazine Other
If other, please explain:
How did you hear about WellWorX?
Channel 3 TV Channel 5 TV Yellow Pages MLGW Newspaper Direct Mail Website Other
Tell us how to get in touch with you:
Name
E-mail
Tel
FAX
Please contact me as soon as possible regarding this matter.
