Strength Foundations Enrollment Form [Bring a Friend!] Name * First Name Last Name Pronouns Email * Phone * Country (###) ### #### Current fitness level: Beginner Intermediate Advanced I'm not sure! Select any option below that describes you currently: Pregnant Postpartum Peri/postmenopausal If pregnant or postpartum, how many weeks/months? Any pelvic floor symptoms you're experiencing? Any injuries or limitations? Any health conditions that impact exercise? Anything you'd like Kim to know before your drop in session? Day & date of your drop in session: Emergency Contact * First Name Last Name Emergency Contact Phone Number * (###) ### #### Release of Liability * can be found at https://www.kimberlysmithmovement.com/releaseofliability I have read, understand and agree to the terms of the release of liability Thank you!Kim will confirm your session via email shortly.
