Lesmills Initial Module Training -Registration Form

REGISTRATION FORM
LES MILLS INITIAL MODULE TRAINING

PROGRAM INFO
BODYPUMP^TM	BODYBALANCE^TM	BODYJAM^TM
RPM^TM	BODYCOMBAT^TM	BODYVIVE^TM
BODYATTACK^TM	BODYSTEP^TM	G.E.L
CX 30 ^TM	SH' BAM ^TM
ADVANCE INSTRUCTOR MODULES:
BODYPUMP^TMAIM MODULE 1	BODYBALANCE^TMAIM MODULE 1
RPM^TM AIM MODULE 1	BODYCOMBAT^TMAIM MODULE 1	AIM 2 (Advanced Instructor Module)
BODYATTACK^TMMODULE 1


Dates of Training *
Location *

INSTRUCTOR INFO
First name *
Family Name*
Telephone (home)
Telephone (mobile) *
City of residence
E-mail Address *
Prerequisite
Les Mills^TM instructors require a level 2 industry qualification which which includes a written component of anatomy and physiology or a fitness qualification in the discipline of Exercise to Music (Level 2). This qualification could include MEFITPRO's latest certification courses : G.E.L (Group Exercise Leader) which is exercise to music or FIT-Q (Personal Training) certificates. For the Les Mills^TM programs exercise to music is prerequisite.
CLUB INFO
Name of club
City
Country
Telephone Number
A written confirmation from the club starting that the instructor willhave a regular class on the studio timetable at the venue should be forwarded to the Les Mills department in order to get the international certification.

I agree I have read and understood the terms and conditions that apply to this registration.