WORKSHOP SIGN-UP FORM
Workshop:
Workshop Date:
First Name:
Last Name:
Email:
Phone Number:
Gender:
Male
Female
How did you hear about this Workshop?
Through the Ottawa Heart Institute
On CTV at Noon - Beth's show
Recommended by a friend
Attended Beth's workshops in the Past
Member of Women on Wheels
Found Peak Performance on Twitter
Read Beth's Blog
Heard Beth on the Radio
Other Comments:
