Family Inquiry Form For 1 adult and 1 child, or 2 children Participant #1 Name * First Name Last Name Participant #1 Phone * (###) ### #### Participant #1 Email * Participant #1 Date of Birth * MM DD YYYY Participant #2 Name First Name Last Name Participant #2 Phone (###) ### #### Participant #2 Email Participant #2 Date of Birth MM DD YYYY Address Address 1 Address 2 City State/Province Zip/Postal Code Country How did you hear about Arukah? Are you interested in group nutrition + wellness education for your employees or gym members? (yes or no) * Are you a parent looking for a family program? (yes or no) * In 1-3 sentences, what do you hope to gain from working with me? * Anything else you want me to know? Thank you for submitting your inquiry. I look forward to working with you! You will receive a follow-up email with your next steps in the next 48-business hours. Make sure to add our email to your contacts and/or check your spam/junk folder!
