Adrian's Slimming World

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New Members Form

Member's Area

New Member Registration

New Member Details

Firstname

Surname

Date of Birth

Gender

Postcode

House Number

Address Line 1

Address Line 2

Town

Email Address

Mobile Phone Number

Have you followed the Slimming World plan before?

Yes

Group you would like to attend weekly?

Height (Feet)

Height (Inches)

How did you hear about my group? (choose as many as you like)

Met the Consultant

Message from Consultant

Banner or Poster outside the venue

Twitter

Letter from Consultant

Slimming World Website

Facebook Post about this group

Advert in Local Magazine

GP Surgery

Slimming World App

Leaflet through my door

Searched online, Google

Local Newspaper Advert

Recommended by a friend

National Advert

Poster with group details

Article in Local Newspaper/Magazine

Reader offer in Newspaper/Magazine

Medical Information

are Pregnant

are Breastfeeding

have Diabetes

have a history of eating disorders

have had weight loss surgery

Do you consider yourself disabled

Do you have a partner living at home?

Do you have children living at home?

What is your occupation?

Occupation Full-time/Part-time

Anything else you wish to tell your consultant? (Specific targets you are working towards?)

Thank you for your Registration, a huge welcome to the Slimming World Family.

Oops, there was an error with your registration.

Please try again later.

How much does it cost?

Standard Members

Our joining fee is just £10.00. You will be directed to pay by card online after you complete your registration form.

Click to Join Group

New Members - Monday 6pm Monday - 9.30am Tuesday - 9.30am Tuesday - 6.30pm Wednesday - 6.30pm

Adrian's Slimming World

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