NEW CUSTOMER FORM ► PRIMARY PERSON * First Name Last Name Phone: * (###) ### #### Email: * Date of Birth: MM DD YYYY Occupation: ► ADDITIONAL PERSON First Name Last Name Phone: (###) ### #### Email: Date of Birth: MM DD YYYY Occupation: ► HOW DID YOU LEARN ABOUT TODOS CLUB? Social Media Google Search Walk In Friend Referral Gift Certificate Promo Flyer Other ► WHICH SERVICES WOULD YOU LIKE TO RECEVE? Yoga Mat Pilates ► WHAT BENEFITS WOULD YOU LIKE TO ACHIEVE? PHYSICAL: Flexibility, Balance, Posture, Coordination MENTAL: Memory, Focus, Motivation, Relaxation ATHLETIC: Fitness, Strength, Endurance, Stamina ARTISTIC: Musicality, Expression, Rhythm, Innovation INDIVIDUAL: Confidence, Self-Discipline, New Hobby, Weight Loss SOCIAL: Teamwork, Friends, Enjoyment, Communication Thank you!
