Please fill out the form questions and a team member will reach out to you promptly to get you started at one of our affiliates!

For any immediate questions or concerns, please text or email Jared Miller:

jared@kealafoundation.com
808-651-6653

Name

First Name

Last Name

Email

Phone

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Date of Birth

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DD

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What is your gender?

Which of our affiliates do you live closest to?

Memberships allow you to attend any/all.

Injury History

List any major surgeries or anything we should know

Do you have a heart or health condition that would prevent you from participating in strenuous physical activity.

If "yes," please share below, mark "no" if none.

How did you hear about us?

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