Thurrock Programme Registration

1

Eligibility

Please enter a height measurement between ".$minHeightCm."cm and ".$maxHeightCm."cm.

Please enter a height measurement between ".$minWeightKg."kg and ".$maxWeightKg."kg.

Please enter a waist measurement between ".$minWaistCm." and ".$maxWaistCm."cm.

Please enter a valid date of birth.

Please enter a valid postcode.

Error, Please check you have completed all of the fields above and try again. If the problem persists please contact us for assistance.
Thank You, You are eligible to enter the Thurrock Programme. Please complete the rest of the form below to register.
2

What are your goals?

3

Lifestyle

What are the main causes of your diet or exercise issues?

4

Dietary preferences and tastes?

5

Previous Diets

Have you tried to lose weight in the past? What type of diet did you follow and what was the outcome?

6

Summary

Goals
Lifestyle
Dietary Preferences
Height
Weight
Waist
7

Registration Details

Please select your title

Please enter your first name, first name's cannot include numbers or special characters.

Other Names cannot include numbers or special characters.

Please enter your first name, first name's cannot include numbers or special characters.

Please select your gender.

Please select your ethnicity.

Please enter a valid email address.

That email address is already registered, please login.

The Username is already taken please choose another one.

The Username must be more than 4 characters and less than 50 characters.

Error, Please check you have completed all of the fields above and try again. If the problem persists please contact us for assistance.
Sorry, You are not eligible for the Thurrock Programme. You can still register for one of our other programmes.
Thank You, you have been registered on the Thurrock Programme and a confirmation email has been sent to the email address you provided. If you do not receive the email please contact us for assistance.