Free-Week Membership

GET MORE OUT OF LIFE

Thank you for your interest in Fitness World West. Please fill in this short survey to receive a free week membership. First time guests and local ID required.

Name:

Address:

Phone:

* required

Fax:

Email:

We are prepared to work with people suffering from any of the following. Please check areas of concern.

fibromyalgia

arthritis

low back pain

heart disease

sport-related injuries

Check below any of the following that affect you or your family.

high blood pressure

lack of energy

sleep disorders

overweight

stress

high cholesterol

Please check all programs at Fitness World West that are of interest to you.

strength training

group cycling

zumba

Pilates

step/aerobics

Women-on-Weights

Are you currently exercising on a regular basis?

Yes

No

How long has it been since you were on a routine exercise program?

30-90 Days

6 months to 1 Year

Over 1 Year

Where are you exercising now?
Would you like to receive a free fitness assessment that evaluates your body fat percentage, blood pressure, cardiovascular endurance, strength, and flexibility?

Yes

No

Comments or Questions:
 

Fitness World West
3200 Westown Parkway
West Des Moines, IA 50266
(Across From Valley West Mall)
Phone: (515) 223-5111

FACILITIES HOURS:
Monday-Friday
5:00 a.m.- 11:00 p.m.
Saturday & Sunday
7:00 a.m. - 7:00 p.m.

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