Heston West Big Local

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* 1. Have you been to a Boxing session before?

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* 2. If you have never been to Boxing before, what has been your main barrier

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* 3. What is your MAIN exercise goal?

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* 4. Please choose which best describes your lifestyle.

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* 5. On a scale between 1 to 10 how healthy do you feel at the present time? (1 - Very Unhealthy to 10 - Healthiest I have ever been)

1 10
i We adjusted the number you entered based on the slider’s scale.

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* 6. Do you have any medical issues/disability? (I.e. Are you taking any medication and/or have a health condition we should be made aware of before partaking this these sessions)

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* 7. Have you had a serious head injury, concussion, health issues in the last 30 days?

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* 8. In the last 12 months, have you received tuition from an instructor or coach to
improve your performance in any sports or recreational physical activities?

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* 9. Would you be interested in any of the following Big Local activities?

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* 10. What is your name, contact email/number? It would be great to know who the feedback is from, but you can always type "anonymous" if you don't want to divulge :)

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