HQ Accountability Groups – Sign Up Questions
Name:
(Required)
First
Last
Address:
(Required)
Street Address
Address Line 2
City
State / Province / Region
Eircode
Mobile:
(Required)
Email:
(Required)
Date of Birth
(Required)
DD slash MM slash YYYY
Height
(Required)
Current Weight
(Required)
Currently, what are you activity levels like? I.e. is your job sedentary or are you on the move, do you walk, swim, workout etc. Please advise in the space below:
(Required)
What are your current eating habits like? Give us an outline of what an average day looks like food wise including all meals, snacks, nibbles and beverages. Use space below to detail:
(Required)
What is your sleep pattern like? Please advise..
(Required)
Are you on any medication at the moment, please advise…
(Required)
€40 per Month
**Once payment is made and sign up is complete you will receive a welcome email which has a link to the private Facebook group.
Due Today and Recurring Monthly Fee:
Credit Card
