Intekai Wave Diet Registration Apply Discount Coupon At Intekai, we want our clients to be rewarded. Simply take advantage of the discounts provided through our coupon codes. Coupons are applicable once per client and only available until the expiration date. Some exclusion may apply. See coupon for details.Enter Coupon Code Type or paste a valid coupon code here to receive a discount for this ITK diet system. Personal InformationInstructions Please complete this section with your personal details.First Name *Last name *Date of Birth *Age *Weight *eg. 150lbs or 70 KgHeight *eg. 5ft. 4inAddress *Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryEmail *Mobile (including area code) *Whatsapp (including area code) Martial Status MarriedSingleOtherGoal Weight *eg. 150lbs or 70 KgHealth Goals State your waist size and any other goals you would like to achieve. Employer Information (Optional)Instructions Please complete this section with your employer's details.Occupation Employer Address Street AddressApt, Suite, Bldg. (optional)CityState / Province / RegionPostal / Zip CodeAfghanistanAlbaniaAlgeriaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCentral African RepublicChadChileChinaColombiaComorosCongo (Brazzaville)CongoCosta RicaCote d\'IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast Timor (Timor Timur)EcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceGabonGambia, TheGeorgiaGermanyGhanaGreeceGrenadaGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiKorea, NorthKorea, SouthKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayOmanPakistanPalestinian TerritoryPalauPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint VincentSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited States of AmericaUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamWestern SaharaWestern SamoaYemenZambiaZimbabweCountryEmployer Coach ContactInstructions Please select the best option that suits you. How often do you want to be contacted by your assigned Coach?DailyOnce per week2-3 times per week4-5 times per weekFortnightlyOnce per monthTwice per month4-5 times per monthOccasional Check-insNever ITK Birthday ClubInstructions All members are automatically added to our Birthday Club. Please confirm an option below. Please add me to the birthday clubPlease DO NOT add me to the birthday club How did you find out about us?Instructions Tick all that applyMedium Social MediaWeb SearchTrainerYellow pagesReferralNewspaperFriendFlyer/BrochureIf you selected "Referral" as one of your choice(s) above, please let us know who the person is. Weight IssuesInstructions Check all that you believe contributes to your weight issues.Issues DEPRESSIONSTRESSBOREDOMPUTTING OTHERS FIRSTSELF LOATHINGSOCIAL EATINGTIME MANAGEMENTCHILD HOOD HABITSANGERSADNESSBINGE EATINGLONELINESSCOMFORT EATINGEATING WHAT IS AVAILABLE Conditions / Age-rangeInstructions Please select one or more of the conditions or age groups below: Age 12-18 (Attending School)Age 12-18 (On Holiday or Home Schooled)Polycystic Ovarian Syndrome (PCOS)DiabetesAnemicOver 60 years oldDiverliculitisHigh Blood Pressure DietInstructions Please answer the following questions to the best of your knowledge.Are there any foods you deeply dislike but will eat? Are there any foods that you will never eat? Have you tried dieting in the past? YesNoHow recently have you dieted? How much weight did you lose? eg. 10lbsWhen did you regain the weight lost? Do you have any dietary restrictions? Non-Disclosure Agreement INTEKAI (ITK) ACADEMY OFFICE at 12 Coliston Drive, Kingston 10. [hereafter called the Discloser] The Discloser intends to disclose information (the Confidential Information) to the Recipient for the purpose of the ITK Weight Loss Programme. The Recipient undertakes not to use the Confidential Information for any purpose except the Purpose, without first obtaining the written agreement of the Discloser. The Recipient undertakes to keep the Confidential Information secure and not to disclose it to ANY THIRD PARTY {including but not limited to Trainers, Instructors, Therapists, Coaches, Wellness Coaches, or Pastors}, EXCEPT TO ITS PROVIDING OFFICIAL PHYSICIAN, who need to know the same for the Purpose, who know they owe a duty of confidence to the Discloser and who are bound by obligations equivalent to those in clause 2 above and this clause 3. The undertakings in clauses 2 and 3 above apply to all of the information disclosed by the Discloser to the Recipient, regardless of the way or form in which it is disclosed (Including but not limited to e-mail, text, messaging, photos, video, voice messaging, verbal, recorded or via third party), but they do not apply to: any information which is or in future comes into the public domain (unless as a result of the breach of this Agreement); or any information which is already known to the Recipient and which was not subject to any obligation of confidence before it was disclosed to the Recipient by the Discloser. Nothing in this Agreement will prevent the Recipient from making any disclosure of the Confidential Information required by law or by any competent authority. The Recipient will, on request from the Discloser, return all copies and records of the Confidential Information to the Discloser and will not retain any copies or records of the Confidential Information. Neither this Agreement nor the supply of any information grants the Recipient any licence, interest or right in respect of any intellectual property rights of the Discloser except the right to copy the Confidential Information solely for the Purpose. The undertakings in clauses 2 and 3 will continue in force indefinitely. This Agreement is governed by, and is to be construed in accordance with, Jamaican law. The Jamaican Courts will have non-exclusive jurisdiction to deal with any dispute which has arisen or may arise out of, or in connection with, this Agreement. *I STATE THAT THE INFORMATION PROVIDED IS ACCURATE, AGREE TO THE TERMS AS STATED ABOVE, UNDERSTAND ALL OF THE ABOVE. VerificationPlease enter any two digits *Example: 12This box is for spam protection - <strong>please leave it blank</strong>: