Active Sisters - women in Sports

Name

Age *

Are you exercising? *

Yes

No

How do you feel about your current level of fitness *

Good

Bad

Could be better

How often *

What motivated you to excersise? *

Endurance/Stamina

Back Problems

Combat Cholesterol

Body Weight Loss

Reduce Body Fat

Re-Shaping Toning

Flexibility

Speed / Power

Body Weight Gain

Reduce Stress

Improve Self Esteem

Injury Rehabilitation

Reduce Blood Pressure

Increase Muscle Mass

other

What will STOP you to excersise? *

I have an injury or a disability

I am too fat

I am too old

I am not the sporty type

I am too embarrassed to train

I need to relax and rest in my spare time

I have not got the energy

I would never keep it up

I don't enjoy physical activity

I don't have time

I have young children to look after

There is no one to train with

I can't afford it

There are no suitable facilities nearby

Other

Which part of your body would you like to work on? *

Arms

Legs

Stomach

Chest

Back

Other

How Active are you?

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