Wright Fitness & Nutrition

Live Leaner, Stronger & Happier

Prototype — no data is saved

Fitness and nutrition the Wright way

Health Coaching & Exercise Training Registration

Please complete the information below, choose your program, review the policies and sign electronically.

Test version: this page does not transmit, email or store any information. Use fake information while testing.

Your information

Tell us who is registering for the program.

First name *

Last name *

Age *

Phone *

Email address *

City *

State *

Choose your program

Select one program. Program timing begins on the date of your first session, online or in person.

Health Coaching

4 sessions · 45 days

$600

Health Coaching

8 sessions · 90 days

$1,000

Exercise Training

45 days · up to 10 sessions

$500

Full Program

60 days · up to 5 health coaching + 10 exercise sessions

$1,300

Online Metabolism Program

Online program

$300

Online Body Transformation Blueprint

Online program

$1,200

Add DEXA for $100
Optional add-on shown on the original registration form for Exercise Training.

Program policies

Please review these terms before signing.

Program timeframe. Your program begins on the date of your first session, online or in person, and must be completed within 90 days or less depending on your program. Any sessions not completed within their timeframe will be forfeited, with no exceptions.

Cancellation or rescheduling. Any Health Coaching or Exercise Training session must be cancelled or rescheduled at least 12 hours beforehand to avoid forfeiture of that session. Sessions cancelled the day of will be forfeited, with no exceptions.

Payment. Payment must be submitted on or before your first session. No refunds, no exceptions. The current paper form lists Venmo @Wright-Fitness-1, credit card, cash, check in person, or mailed payment to 1649 State Hwy 248 Unit 110, Branson, MO 65616.

Health & liability agreement

Read the full agreement and complete each acknowledgement.

Wright Fitness & Nutrition (Adam) does not diagnose, treat or cure any illness or medical conditions. The information and suggestions provided in Adam’s coaching and training programs come from his own interpretation of the available research, study and experiences of doctors, scientists and other health & fitness professionals discussing these topics as well as Adam’s personal experiences and study of each concept. Adam’s suggestions are NOT to be considered medical advice or personal prescriptions. Adam encourages all participants to obtain a physical examination from their physician prior to beginning this program.

By submitting this signed registration form and payment to Adam, I acknowledge that this is not a doctor prescribed or overseen program and that I am healthy enough to participate in this program and have been cleared by my physician to do so. Additionally, I hereby release Wright Fitness & Nutrition and Adam Wright from liability for accidental injury, illness or damage to my health that I may incur as a result of participating in this program. I hereby assume all risks connected therewith and consent to participate. I acknowledge my weight loss results and improved health are not guaranteed and that results will vary person to person.

I hereby acknowledge that I have read, understand and agree to the above conditions. Any questions that I had concerning these conditions have been answered to my satisfaction.

I understand the program timeframe and that unused sessions may be forfeited. I understand the 12-hour cancellation/rescheduling policy and same-day forfeiture policy. I have read and agree to the health, medical and liability statements above. I understand that weight loss and improved health results are not guaranteed and vary by person.

Electronic signature

Type your full legal name to sign this registration.

Typed signature *

For the live version, we can also record the exact submission timestamp and other audit information.

Date

Please complete all required fields, select a program, and check each acknowledgement before submitting.

Ready to submit?

Your selected program and total will appear here once you choose an option.

Prototype only. Nothing entered on this test page is sent anywhere or saved. The production version will use secure server-side processing rather than relying on browser-only storage.

✓

Registration complete

This is the prototype confirmation screen. In the live version, this is where we can show next steps, payment instructions, email confirmation and portal access.