BeWell 101 Summer 2024 Application

Name

Georgia Tech Email

Georgia Tech Affiliation

What are your fitness goals?

Please detail specific fitness goals you are hoping to accomplish.

Have you previously tried to meet your goals?

Please let us know what, if anything, you have done in the past to achieve your fitness goals. Please list things that led to success as well as those that did not.

Can you attend all scheduled classes?

Consistent participation is extremely important to progress. Please ensure your schedule would allow you to miss no more than 3 class meetings prior to registering.

This course will meet Mondays and Wednesday from 12:00-1:00 from May 20th through July 31st. Nutrition meetings will begin Thursday, May 23rd and will meet each Thursday from 12:00-1:00 pm.

*no classes 5/27, 6/19, or 7/4

Have you ever closely tracked your nutrition?

Participants are requested to utilize the Premium version of MyFitnessPal to share food logs with the program dietician (currently priced at $19.99/month or $79.99/year)

*the base free level version of MyFitnessPal will still provide everything needed for program participation*

What are your current physical activities?

Please detail your current activity level and what activities you enjoy most. Please also list if you are not currently active.

Do you have any physical limitations?

This includes any limitation a trainer would need to know about to most appropriately prepare workouts.

Do you have any prior injuries?

Participant Agreement Statement

Thank you for your interest in BeWell!

Form Date Field

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