chek exercise coach - hqh fitness€¦ · · 2010-07-01the chek exercise coach program will help...

[email protected] | www.hqh.com | 800 552 8789

2 CHEK EXERCISE COACHWhat is a CHEK Exercise Coach?

A CHEK Exercise Coach possesses the skills and knowledge to design and implement personalized exercise programs that incorporate

traditional exercise with mind-body exercises. A key component that defines a CHEK Exercise Coach is the series of assessments used to identify core and autonomic nervous system dysfunctions. The CHEK Exercise Coach Program will help you accurately assess even the most complex client and lead you towards designing a scientifically sound program and achieving exceptional results.

CHEK Exercise Coaches stress excellent exercise technique and know that to produce the desired result, exercises must be performed correctly. They understand how energy-balancing exercises reduce total body stress and know when to use these types of exercises with different clients.

What Makes This Program Different?

5-day intensive course If you are truly interested in becoming a results-achieving exercise professional, then attend the CHEK Exercise Coach course. You will benefit from five intense days of lectures and practical training.

Individualized attention There is a maximum of 16 people per instructor in each course. This ensures you receive plenty of personal attention and interaction with the CHEK Faculty.

Train with the best in the world The CHEK Faculty have been hand-picked and trained to the highest standards. You will be learning from highly experienced, successful exercise specialists - among the best in their fields.

Applied knowledge is power The traditional quote says “Knowledge is power.” At the C.H.E.K Institute our philosophy is that if you cannot apply knowledge, it is virtually useless. This course is packed with hands-on tools and techniques that you can use with your clients immediately.

CHEK

EXERCISE COACH

Corrective

High-performance Exerc

ise

Kinesiology

"(I am) enlightened and now realise the breadth and enormity of learning at my disposal. Thank you for opening my eyes to what I know and what I need to know."

Tony Giannone - Personal Trainer, Melbourne, Australia


3 BENEFITS

When you complete the CHEK Exercise Coach program and pass the exam, you may reap the following benefits:

Be one of the top professionals in the exercise field In today’s rapidly changing world, the people who stay ahead are those who are continually learning and expanding their skills. When you are a CHEK Exercise Coach, you will be able to advance ahead of your co-work-ers and competitors simply because of the results your clients achieve.

Achieve financial security C.H.E.K Institute-trained Professionals have successfully increased their fees 100% - 300% and are finding themselves with as many clients as

they can handle! Wouldn’t you like to work less and earn more?

Gain advanced skills that make a meaningful difference in the lives of your clients You will be able to design effective exercise programs for people who have previously had little success in using exercise to reach their goals. You will know what kinds of exercise will produce the results they are seeking and help them implement balanced exercise into their lives. Success comes through helping others.

The opportunity to be your own boss Perhaps you have dreams of starting your own business or moving out of the traditional gym setting. Students often open their own business or studio after attending a C.H.E.K Institute Training Program.

Website listing All CHEK Exercise Coaches in good standing with the C.H.E.K Institute are listed online in the searchable database at the C.H.E.K Institute website. This is a free marketing resource! Potential clients in your area can find your contact details and read your bio. We refer everyone who calls the Institute seeking a C.H.E.K Institute-trained Professional to the database.

Membership to the CHEK ForumThis electronic forum is exclusively for people who have attended one or more of the C.H.E.K Institute Training Programs. An invaluable way to stay in touch with top professionals from around the world, share ideas and ask questions in a confidential setting. Visit www.chekcon-nect.com


4 COURSE DESCRIPTION

This highly practical five day course will give you the skills to become a superior exercise professional. After

attending the CHEK Exercise Coach Program, you will be able to effectively administer individualized exercise programs for all types of clients. Correct technique is emphasised throughout the course, with plenty of hands-on assistance from the CHEK Faculty.

A key component of this course is the integration of mind-body fitness and traditional exercise prescription. You will understand how different types of exercise, from Tai Chi

to cardiovascular conditioning to weight-training, affect both parts of the autonomic nervous system - an often neglected factor that is vital to achieving success with your clients.

Using the C.H.E.K Institute's unique system of assessing physiological load, developed by Paul Chek, you can determine the amount of physical and emotional stress placed upon the body. Using this system you will be able to implement results-producing programs that enhance your client’s function and overall well-being. At the conclusion of this course, you will be able to:

• Assess your client’s physiological load and write exercise programs to address low, moderate and high overall loads.

• Assess functional deficits and imbalances in the core and back musculature.• Design personalized exercise programs that balance the autonomic nervous system. • Understand how optimizing posture not only improves function, but increases overall

wellness.• Implement a plethora of exercises that enhance function.

By combining the knowledge of orthopedics, exercise prescription, performance conditioning and alternative healthcare modalities C.H.E.K Education provides a holistic, integrative perspective that helps you attain all your wellness, health and fitness goals.

There are numerous training courses, seminars and programs for many different things - few of which guarantee competence. To be awarded the C.H.E.K Institute seal of approval, you must prove that you have the hands-on skills that separates you from the rest.

For more information on the program or to readour Terms & Conditions visit www.hqh.com


5 WHAT PEOPLE ARE SAYINGPraise for the C.H.E.K Institute

“The C.H.E.K Institute represents what the future holds for the fields of exercise and rehabilitation. I have no doubt that (The C.H.E.K Institute’s) information and techniques will be the industry standard in the near future."Terrence Thomas - Florida, USA

Increase your rates and attract more clients

"I have recently (attended) the C.H.E.K Institute Exercise Coach course in the UK. Two weeks later I am reaping the benefits! Besides the fact that my prices have now raised a considerable amount, I find myself delivering a more comprehensive service to my clients. The knowledge and skills I have learnt from the course have greatly impressed those who I coach and as a result my client base has increased...in just two weeks. I can’t wait to see what happens in two months time!"James Wild - Surrey, Great Britain

Exercise Coach

"Terrific course with great practical (information), easy to implement. Well worth the time and money. Looking forward to the next course."Jared Ahale - Centre Assistant Manager, Victoria, Australia

"World class best practice information. Exciting to be a part of it."David Millar - GP, Perth Australia

"Liked the gradual layering or increase in difficulty as the week progresses with (the) case study as it is learned. Best course done so far, will be doing Level 1 next."Steven Alexoudis - Adelaide, Australia

“Amazing amount of information that will take a lot of extra reading and study to absorb. But overall the most intense, rewarding workshop I have ever done."Jane Stevens - Personal Trainer, Melbourne, Australia

"[The] week was, without doubt, the most enlightening, exhilarating, and empowering time I've ever experienced. Words can't describe how I truly feel...You don't know how much I appreciate and respect your amazing abilities, passion and professionalism." Wayne Daniels - California, USA

C.H.E.K Practitioner Level 1

"Fantastic material once again. CHEK Level 1 is a great progression from Exercise Coach. New, deeper concepts were introduced and explored to create a better assessment framework and program design." Nathan Walshe - Physiotherapist & Trainer, NSW, Australia


6 PREREQUISITES1. The CHEK Exercise Coach program is open to all, including those new to the fitness profession. We do recommend that you have a working knowledge of anatomy, physiology and exercise. A list of preparatory resources is available from the Institute.

2. Prerequisite CoursesThree C.H.E.K Institute courses and two books provide the framework upon which the CHEK Exercise Coach Program is built. It is essential that you have completed these at least 30 days before the start of the course either by attending a live seminar or successfully passing a correspondence course. These courses are: (all prices listed are ex gst)

Scientific Core Conditioning (NZ $567.31): (AUD $453.00)The most comprehensive program on condi t ioning the abdominal musculature.

Scientific Back Training (NZ $480.77): (AUD $384.00)An essential tool to maintain a healthy back and reduce the risk of back injury both in and out of the gym.

Program Design (NZ $357.77): (AUD $286.00)This course brings together the wisdom of four experts in strength, conditioning and rehabilitation; Paul Chek, Coach Charles Poliquin, Coach Kim Goss and Jerry Telle.

Movement that Matters by Paul Chek (NZ $30.00):(AUD $24.00)Movement that Matters provides trainers and fitness enthusiasts with the tools needed to create functional training programs. Understand the body's five differ-ent reflexes, and the six defining characteristics that determine if an exercise is truly functional.

How to Eat, Move & Be Healthy! by Paul Chek (NZ $47.98): (AUD$40)How to Eat, Move and Be Healthy! serves as the basis of the C.H.E.K Institute's philosphies covering a wide variety of topics such as nutrition, exercise, stress management and healthy lifestyle coaching techniques.

Note: The correspondence courses include DVDs, a manual and a test that must be completed and returned to the C.H.E.K Institute in order to receive a certificate of completion and any CECs or CEUs. Seminar attendees receive a certificate of attend-ance at the end of each seminar. For full details on these correspondence courses, visit www.chekinstitute.com


7 EXAMINATION PROCEDUREPractical Portion: The CHEK Faculty will perform a con-tinuous assessment of your practical skills during the course, to ensure you have met the required standard.

Written Portion: During the course you will be given Case Histories to complete. You must pass each case his-tory. At the end of the course, you will be given a rigorous written exam that must be completed within 45 days after the course ends.

Investment (all prices listed are ex gst)

CHEK Exercise Coach Program NZ $2,650.00 : AUD $2,250.00

CHEK Exercise Coach Prerequisite Package NZ $1,269.23 : AUD $1,012.00Order all three prerequisite courses as a package and save 10%!This package includes the three DVD correspondence courses:• Scientific Core Conditioning (regular price $567.31) • Scientific Back Training (regular price $480.77) • Program Design (regular price $357.77)

*Movement that Matters and How to Eat, Move and Be Healthy! not included.

Complete CHEK Exercise Coach Package NZ $3,680.73 : AUD $3,093.25Save even MORE when you enrol for the CHEK Exercise Coach Program and purchase all three prerequisite courses at the same time!

INTEREST FREE Payment Plans available. Please call or visit the website for more information.

How to Attend

1. Decide which program date you would like attend. A calendar of events for Australia and New Zealand is available on the HQH website.

2. Register for the course (see below) and purchase all the prerequisites. We recommend that you give yourself at least 90 days prior to the course in order to complete the prerequisites and your tests.

3. Complete and turn in all your prerequisite tests at least 30 days prior to the start of the course for grading.

How to registerRegis ter by cal l ing 1.800.552.8789 ( in AU) or 0.800.552.8789 ( in NZ).A registration form has also been provided on page 15. Alternatively visit our website www.hqh.com to register online directly.


Suzi Nevell CP4, HLC 3A registered New York Physical Therapist, Suzi has worked in the fields of sports and spinal physiotherapy for over 15 years. With a post-graduate diploma in Orthopedic Manual Therapy from New Zealand, she has worked with the Orthopedic Surgeon for the US Tennis Association and has owned her own physical therapy practice. Suzi is a Senior CHEK Faculty member.

MEET THE CHEK FACULT Y [SOUTH PACIFIC]

Paul Chek HHP Founder of C.H.E.K InstitutePaul Chek is a world-renowned expert in the fields of corrective and high-performance exercise kinesiology and is the founder of the C.H.E.K Institute, based in California, USA. For over 25 years, Paul’s unique, holistic approach to treatment and education has changed the lives of many of his clients, his students and their clients. By treating the body as a whole system and finding the root cause of a problem, Paul has been successful where traditional approaches have consistently failed. He has produced over 60 DVDs, 17 correspondence courses, 4 advanced-level training programs and six books. Paul is a sought after international presenter and consultant for organizations

such as the Chicago Bulls, New Zealand’s Auckland Blues, the PGA of Sweden and the UCSD Spine and Joint Conditioning Center.

Mark Buckley B.PhEd, CP4, HLC 2 Mark has extensive clinical and practical experience, including heading the correc-tive exercise program of a hospital-based musculo-skeletal rehabilitation program in Wellington, New Zealand. He is the co-owner of Olympic Gym in Dunedin, NZ and conditioning consultant to some of New Zealand’s leading Rugby players. Mark is a Senior CHEK Faculty member.

Donal Carr CP4, HLC 3Donal Carr is the PT Training & Development Manager for Fitness First Australia, in which he runs over 200 workshops and lectures a year for over 2000 personal trainers. Donal has been presenting for over ten years and has a consultancy business where he regularly speaks to corporate networks on a wide variety of topics. Donal is also a GRAVITY Elite Master Trainer, NSCA, NCEF 2, ITEC, and owns a health & fitness busi-ness in Sydney with his wife Cathy.

Have you visited www.chekconnect.com lately?

CHEK Connect is an online forum for CHEK Professionals where you can list yourself as a CHEK Practitioner and include your various qualifications. Also read, listen to or watch free articles and information from CHEK Faculty and the CHEK Institute. This website is highly recommended.

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P R O F E S S I O N A L D E V E L O P M E N T REQUIREMENTS

How to Maintain Your Status as a CHEK Exercise Coach?

You will be C.H.E.K Institute Recognized once you complete your CHEK Exercise Coach course and pass the test. To remain C.H.E.K Institute Recognized, and to continue

receiving the benefits of a C.H.E.K Institute-trained Professional, students are required to maintain a standard of professional development measured every two years. This 2-year measurement is the C.H.E.K Institute-trained Professional Renewal Program, which consists of 5 easy steps:

Step 1: Earn 50 Professional Development Credits every two yearsBetween October 1st of an even year to September 30th of the following even year, (i.e. October 1, 2006 to September 30, 2008), you will need to earn 50 PDCs, which can be acquired many different ways, such as attending seminars, writing book reports, completing case histories and so on.

Step 2: Obtain CPR certification All C.H.E.K Institute-trained Professionals must hold a current CPR certification.

Step 3: Hold current liability insuranceAll C.H.E.K Institute-trained Professionals must be covered by professional liability insurance.

Step 4: Complete the C.H.E.K Institute-trained Professional renewal formThis includes the C.H.E.K Institute Code Of Ethics and Professional Practices and Disciplinary Procedures. By signing the renewal application form you agree to adhere to the C.H.E.K Institute Code of Ethics and the Professional Practices and Disciplinary Procedures.

Step 5: Submit the C.H.E.K Institute-trained Professional Renewal FormReturn the renewal form with proof of Professional Development Credits, CPR certification and liability insurance, plus the renewal fee by the due date.

Complete information on the C.H.E.K Institute-trained Professional Renewal Program is sent to you once you pass the CHEK Exercise Coach exams and receive your certificate. For more information, please contact the Education Department at the C.H.E.K Institute. e-mail: [email protected] or call 1.800.552.8789 (+1.760.477.2620 internationally).Alternatively, feel free to contact HQH and we will endeavour to answer any questions you may have.

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10 WHERE TO FROM HERE?INTRODUCING: C.H.E.K Practitioner Program

The C.H.E.K (Corrective High-performance Exercise Kinesiology) Practitioner Program is ground-breaking. This four-level program is designed to be completed over two to four

years as it draw inspiration from several fields of health and fitness such as orthopedics, cor-rective exercise, massage therapy, chiropractices, alternative therapies and strength training. The goal of the program is to provide you with the knowledge necessary to work with your clients to achieve optimal results. The C.H.E.K Practitioner Program is oriented directly to develop practical skills by mastering the underlying theories along with the hands-on ap-plications. Even after competing just the first level of the program, you will become a more skilled professional.

Explaining the CHEK Progression:

CHEK Exercise Coach (prerequisites: Program Design course;

Scientific Core Conditioning course; Scientific Back Training course; How to Eat, Move and Be Healthy!; Movement that Matters)

C.H.E.K Practitioner Level 1 (CP1)(prerequisites: CHEK Exercise Coach; Flatten Your Abs Forever DVD; Advanced Program Design course; Equal, But Not the Same course)

C.H.E.K Practitioner Level 2 (CP2)(prerequisites: C.H.E.K Practitioner Level 1; Dynamic Medicine Ball Training course; Swiss Ball Training

course; Advanced Swiss Ball Training for Rehabilitation course)

C.H.E.K Practitioner Level 3 (CP3)(prerequisites: C.H.E.K Practitioner Level 2; 2-10 Case Histories)

*plus possible reading materials

C.H.E.K Practitioner Level 4 (CP4)(prerequisites: C.H.E.K Practitioner Level 3; 2-10 Case Histories)

*plus possible reading materials

Master C.H.E.K Practitioner(Exams, thesis, presentation)

I t can take anywhe re f rom 2 - 5 yea r s to comp le te t he f u l l C .H.E .KPractitioner Program. You choose the level that you wish to go to. Some peo-ple choose to achieve L3 status, while others are happy with the knowledge gained from L1 or L2. If you are motivated to become L4 or a Master C.H.E.K Practi-tioner, then we can guarantee you will become a well-sought after Practitioner.


11 OVERVIEW OF THE PROGRAM

The C.H.E.K Practitioner Program is designed to produce the finest and most highly trained exercise practitioners and strength training specialists in the world. Unlike any other pro-

gram around for exercise professionals, it is completed in 4 intensive modules, each taught in a small group forum.

CP1 (FIVE days)C.H.E.K Practitioner Level 1 expands the CHEK Exercise Coach’s knowledge of exercise and its sci-entific, therapeutic, and performance applications. Students learn infant development assessment as a means of identifying the physical, emotional and mental etiology of movement inefficiency.Paul Chek’s Primal Pattern® system of movement analysis is taught as a seamless progression from infant development. Learn to identify which Primal Pattern® movements are essential to each individual’s work, home, recreational, and/or sporting environment. Using a variety of exercise modalities, you will be able to customize any exercise to suit each client’s ability and skill level. All instruction is based on an integrated holistic model for assessing movement disorder and restoring functional movement. Also learn how to identify which systems of the body must be balanced to create well-being as part of a skillfully designed exercise program. C.H.E.K Practitioner Level 1 Learning Objectives:1. Learn a holistic, integrated model of Primal Pattern movement assessment.2. Design fully customized exercise programs based on a needs analysis for each client.

CP2 (FIVE days)C.H.E.K Practitioner Level 2 teaches you how to identify red flags as a necessary system of preventing injury through exercise. Learn spinal biomechanics, neurological screening, essential orthopedic screening tests, length/tension assessments, corrective stretching, specific corrective exercise technologies, and how to refer to allied medical practitioners. Advanced level postural assessment using goniometric technology gives you the ability to design highly specific corrective exercise programs. Level 2 Practitioners are an invaluable addition to any medical practice treating work, sports, and recreational orthopedic injuries. They are also key contributors to the professional sports medicine and conditioning teams. C.H.E.K Practitioner Level 2 Learning Objectives:1. Learn how to perform a goniometric assessment of posture and relevant joint range of motion.2. Learn to perform an effective screening of each individual, ruling out any red flags through careful examination of medical history, orthopedic assessment, and length/tension assessment.3. Learn specific corrective exercise for effective spinal or core stabilization.4. Learn to design corrective exercise programs at a higher level.


12 OVERVIEW OF THE PROGRAMCP3 (NINE days)

The C.H.E.K Practitioner Level 3 learns how to assess the body in accordance with Paul Chek’s Totem Pole system of evaluation and correction. Based on developmental and survival reflexes, you will learn to assess key cranial nerve functions, the temporomandibular joint and bite func-tion, cervical, and shoulder biomechanics. Specific orthopedic tests, length/tension assessments, stretches, mobilizations, and corrective exercise techniques are thoroughly covered. You also learn the emotional and mental connections to why people don’t heal. A C.H.E.K Level 3 Practitioner is an excellent team member in any medical practice handling complex cases, and on any amateur or professional sports team where technical approaches to exercise and well-being are needed.

C.H.E.K Practitioner Level 3 Learning Objectives:1. Understand how to correctively perform a comprehensive, full-body assessment of key biological systems.2. Learn how to prioritize therapeutic protocols based on the client’s immediate needs and financial and time commitments.3. Learn how to assess the cervical, temporomandibular, shoulder regions and integrate to design effective corrective exercise and stretching programs in this area.4. Learn the emotional and mental factors related to why people don’t heal. CP4 (NINE days)

A C . H . E . K P r a c t i t i o n e r L e v e l 4 l e a r n s t o i n t e g r a t e a l l t h e t r a i n -ing they ’ve received in each of the lower levels. It begins with a comprehensivereview of all prior C.H.E.K teachings to assure clarity before moving forward. Next, Metaphysics are taught as they relate to reading the body; through correlation of physical and energetic centers. Learn how to address the emotional, mental and spiritual components to health and disease. Using Paul Chek’s unique 4 Doctors system for designing a total well-being pro-gram, you master the use of this state-of-the-art tool. C.H.E.K Practitioner Level 4’s are highly skilled and typically own and operate their own health and exercise centers around the world.

C.H.E.K Practitioner Level 4 Learning Objectives:1. Review and fine-tune all prior C.H.E.K training.2. Master the 7 Chakra System of energy flow in the human body~mind.3. Master the use of Paul Chek’s 4 Doctor system for creating health andwell-being.4. Learn the basics of non-violent communication and sacred listening.

“I am a practicing Physical Therapist with 11 years experience in sports and spinal muscu-loskeletal physiotherapy and have attended numerous C.H.E.K seminars as well as becoming a C.H.E.K Practitioner Level 4. It is my opinion that the C.H.E.K system of corrective exercise is an invaluable adjunct to physical therapy care in particular in the treatment stage once the client no longer requires the acute or sub-acute therapy" Suzi Nevell - Auckland, New Zealand


13 OTHER C.H.E.K INSTITUTE PROGRAMS

CHEK Holistic Lifestyle Coach Program

This three-level program is based upon the techniques that have helped thousands of people increase vitality, decrease stress and

sculpt the body of their dreams. Each level looks in increasing detail at the underlying causes of disease and stress, considering the body as a "system of systems." Using a coaching model, you will learn how dis-ease and stress are preventable through healthy eating habits, lifestyle management and appropriate types of exercise.

You will understand why every meal, every bout of exercise and every late night has a hormonal consequence. You will be given tools, such as in-depth questionnaires, to assess your clients and allow you to determine their readiness for change.

This program exceeds anything you will learn in any other “wellness course” ... this is Holistic Lifestyle Coaching the CHEK way! As Paul Chek says, "An individual’s health lies in his own hands; you are simply there to show him the path."

CHEK Golf Biomechanic IntensiveWelcome to the most comprehensive course on golf conditioning any-where! This program was created by Holistic Health Practitioner Paul Chek, author of The Golf Biomechanic's Manual and world renowned for his expertise in corrective exercise, high performance conditioning and integrated approach to health and well-being.

This seven-day program includes five days of theoretical and hands-on training, followed by written and practical exams taken on the final two days. The entire pro-gram is based on the same techniques used by Paul Chek and the CHEK Faculty with their clients, including some of the top PGA and LPGA players on tour today.

"After nearly 20 years in the fitness industry I found the HLC seminars to be the most powerful tools to encompass body, mind and spirit, and empower one to take their clients to the next level."

Greg Muller (Herb) - Auckland, New ZealandPrior Head Fitness Trainer for Auckland Rugby Union, C.H.E.K Practitioner Level 3, CHEK Golf Biomechanic, CHEK HLC3

Corrective

High-performance Exerc

ise

Kinesiology

CHEK

GOLF BIOMECHAN

IC

Holistic Lifestyle Coa

ch

C.H

.E.K INSTITUTE


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ABOUT HQH

The C.H.E.K (Corrective Holistic Exercise Kinesiology) Institute is an elite educational facility based in California. The C.H.E.K Institute specializes in advanced-level education for

fitness and health-care professionals. The company’s approach to exercise and wellness stems from the training and clinical experience of the Institute's founder, Paul Chek. His multi disciplinary background is reflected in the philosophy of the C.H.E.K Institute - a person should function at optimal health and performance and be able to meet the demands of their environment, whether sitting in an office or engaged in professional sports. The C.H.E.K approach emphasizes assessments followed by personalized programs to ensure success at all levels.

Corrective Holistic Exercise K

inesio

logy

C.H.E.K InstituteSycamore Business Center

2105 Industrial Court Vista, CA 92081 USA

760.477.2620800.552.8789

[email protected]: 760.477.2630

www.chekinstitute.com

ABOUT THE C.H.E.K INSTITUTE

HQH (Highest Quality Health & Fitness) is a New Zealand based company and the South Pacific distributors of the CHEK Programs and products. Originally from Canada, the

Directors of HQH Greg & Nancy Doherty were friends with Paul Chek’s mother. Even at a young age he was certainly an original thinker. While they kept tabs on what Paul was doing, it wasn’t until Paul showed up on their doorstep in 1994 to present his first lecture tour in the South Pacific that they truly saw what he was achieving. They were so impressed with the impact that Paul had on the wide and varied group of students attending. Greg and Nancy then saw the opportunity to help Paul bring his knowledge to Australia and New Zealand on an ongoing basis, and thus began the company that is now known as HQH, distributing only the highest quality products and education available.

Highest Quality Health & Fitness75 Sunrise Avenue, Murrays Bay, North Shore, Auckland 0630Intl Ph: 64 9 478 211 Intl Fax: 64 9 478 9111 [email protected]


15 REGISTRATION FORM

Name:Address:City:State: Postcode:Country:Ph: ( ) Mob: ( )E-mail:

Yes! I would like to register for:Course Date:Course Location:

CHEK Exercise Coach Program Package of 3 pre-req home-study courses

Complete CHEK Exercise Coach Package (Includes the 3 pre-req courses + a 7.5% discount on the 5-day program)

INTEREST FREE Payment Plans available for the 5-day program. Prerequisite Packs must bepaid for in full. Tick the box to the right if you would like this option and we will contact youto organise a payment schedule. Also select a payment method for the prerequisite pack.

Payment by:

Visa MC Amex Cheque Bank Deposit

Card #Exp. CID#

Amount Paid $

Signature:

CHEK Exercise Coach Registration Form

(The C.I.D. number is the last three numbers found on the back of your credit card by the signature plate and for American Express card users it’s the four numbers found on the front right side of your credit card above the credit card number.)

Mail or fax to HQH address or fax number

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