911 FITNESS CHALLENGE

TRAINER HERO APPLICATION

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How did you hear about the challenge?
I, , wish to volunteer my expertise as a Trainer Hero for the purpose of measuring the body composition of competitors registered for the 911 Fitness Challenge. I will provide my services in January 2008 (initial phase) and April 2008 (final phase). I understand that I will not be paid for my assistance and that my contribution is to support the Shriner's Hospitals for Children. Furthermore, I consent and release the use of my photograph, fitness qualifications and contact information to be posted on the 911 Fitness website Trainer Hero Directory.

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*911 FITNESS, Inc.*
18520 N.W. 67 Avenue, Suite 193 Miami, Florida 33015 (305) 297-5328 fax (954) 449-0416
jim@911fitness.com


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