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You can’t put a price tag on your happiness and well-being. That’s why joining Cancer Champions is completely free.

When you join Cancer Champions, you get more than access — you get a personalized program designed specifically for your needs.

Our certified cancer specialists get to know you, and create a plan that supports your fitness, nutrition, and mindset goals so you can feel stronger, supported, and confident, no matter where you are on your journey.

Join Cancer Champions

To sign up for your free Cancer Champions membership, please complete the form below. Your information is kept secure and confidential, and will never be shared or sold.

If you are a Care Partner looking to join, click here.

Contact Information

First Name *

Last Name *

Email Address *

Phone *

Gender Identity *

Date of Birth *

Race *

Are you of Hispanic, Latino/a/x, or Spanish origin? *

Street Address *

Apartment, suite, etc

City *

State/Province *

ZIP / Postal Code *

Country *

Approximate Annual Household Income *

Are you a veteran or active-duty service member? *YesNo

Patient Overview

Type of cancer *

Stage of cancer *

Are you currently undergoing treatment? If so, what is it? (chemo, radiation, etc.) *If you are post-treatment or in between treatments, please specify that here.

Do you (or did you) have any metastases? If so, where are/were they located? (Please list them) *

Who is your oncologist?

What is your medical group?

How can we at Cancer Champions support you? *FitnessNutritionMindsetCommunity

Type of InsuranceGovernment-SponsoredPrivateNone(Type of insurance does not affect membership)

Your Care Partner Info

(or Emergency Contact)

Name

Email Address

Phone

Final questions

How did you hear about Cancer Champions? *

Are you interested in being paired with one of our Mentors/Coaches to support you? *Yes, I'd like to learn moreMaybe laterLearn more about how our Coaches can support you by clicking here.

Do you speak English? *YesNo

I agree *

By participating in the Cancer Champions program, you acknowledge and accept the inherent risks associated with physical activity, including the potential for injury. It is your responsibility to consult with a healthcare professional before beginning the program.

Please double-check your info *Please double-check all your information is correct before submitting

Please do not fill in this field.

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