What’s your name?

What’s your gender?

Male

Female

What's your age?

Please enter a number from 18 to 90.

What's your current height and weight?

What is your current occupation?

What is your primary body composition goal?

Please select one

Shed Excess Bodyfat

Build Muscle / Strength

Both (body recomp)

What motivates you to improve your overall health & fitness?

Select up to 5

Improve how I look

Improve my energy levels

Improve my sleep

Help relieve stress

Help relieve body aches & pain

Improve my confidence / self esteem

Meet new people / make friends

Improve resiliency to illness & injury

Live longer with the highest possible function

Perform better at home

Perform better at work / school

Perform better at sports / hobbies

What motivates you to stick to a program despite adversity, setbacks, failure, etc?

Select up to 5

Seeing improvement / results

Setting & reaching mini goals (weekly / monthly)

Accountability from coach & teammates

Making family / friends proud

I don't want to look like a failure

Recognition / praise

Having fun / I enjoy the daily grind

I know it needs to be done - now or never!

Because I made a committment and I stick to it!

Personal pride / sense of accomplishment

What are your biggest struggles preventing you from reaching your fitness goals?

Please list them out (time, discipline, unsupportive friends / family, etc)

Which best represents you and your current needs?

Please select one

Do it Myself: I'm a self-starter. I just need to know what to do and I'll take action immediately

Done with Me: I thrive in a group setting where I can compete and share wins / losses with teammates.

Done for Me: I'd like to work directly with a coach each week to stay accountable to my personalized plan

When would you like to get started?

Enter a date - can be as soon as today!

Let us know where to send information about your program!

Full Name

Phone

Instagram @handle?

Preferred method of contact:

(if text: confirm previously entered phone number is text-capable)

Text

Call

Instagram

Name

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