Application Form | Mike Calpin

Price and option *

First Name *

Last Name *

Gender *

D.O.B *

Please enter your D.O.B in the following format: dd/mm/yyyy

Country *

Email Address *

Note this is the email address that will be used for all communication. Please check it is correct. Add hello@mikecalpin.com, noreply@mikecalpin.com and applications@mikecalpin.com to your address book.

Contact Number *

Occupation *

Height - Feet/Inches *

Weight - Stones/Pounds *

Please say what you would like me to help you with and what your health and fitness priority is at the moment? *

Example: Lose weight, feel better, improve fitness/health, gain muscle, tone up, to see my abs, post pregnancy weight loss, doing it for my family, lower blood pressure etc.

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Always consult a qualified medical professional before beginning any nutrition or exercise program. The exercise and nutrition suggestions are not intended to substitute professional medical advice. We assume no responsibility for injuries suffered while practicing any exercise program. Always seek the advice of your physician, or other qualified health provider, with any questions you may have regarding any medical condition.