FITNESS BOOKING FORM
Please fill out the form completely to submit your request
* required field
Tuscany Golf Village
Stirling Club (Members Only)
Your Location (If Approved)
Tell Debra how to get in touch with you!
What type of workout session would you like to request?
Weight Training Yoga/Thai Jump Rope Training Golf Fitness Other
Never Tried On & Off Many Programs Worked w/Trainer Previously Elite Athlete
What is your height and weight?
Weight: Select Weight under 150 lb 150-160 lb 160-170 lb 170-180 lb 180-190 lb 190-200 lb 200-210 lb 210-220 lb 220-230 lb 230-240 lb 240-250 lb 250-260 lb 260-270 lb 270-280 lb over 280 lb Height: Select Height under 5' 6" 5' 6" - 5' 7" 5' 8" - 5' 9" 5' 9" - 5' 10" 5' 11" - 6' 6' - 6' 2" 6'2" - 6' 4" over 6' 4"
Please select your primary time choice:
Before 12Noon 1-4PM 5-9PM 10PM or later
Please select your secondary time choice:
Optional: Would you like a personal workout video recording? (Tripod Only--No 3rd party) Yes No
Enter any comments in the space provided below:
Debra Stefan Fitness Services
702-898-4622
www.DebraStefan.com
DebraStefan@cox.net
Home