Challenge Group Application
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Name (first and last)
Age
Gender
Email
What email address is best for me to contact you?
Background Info
Tell me a little about you, your work, your family, your hobbies, etc.
Your WHY
What is your WHY for wanting to change?  Is it your family, your health, for you, etc.?  Why the interest in this challenge pack and workout program?
Health and Medical Conditions
Are there any medical or health conditions that I should know about that could affect your workout regimen, your diet, etc?
Fitness Goals
What are your goals for your personal fitness?  What would you like to achieve?  Be specific (tone up, lose ___ lbs., strengthen, etc.)
Fitness Experience
What is your fitness experience?  Have you ever tried at home workout programs?  What are your favorite ways to exercise?
Nutrition Goals and Struggles
What are your goals nutrition wise?  What are your biggest struggles with nutrition?
Additional Info
Is there anything else you would like me to know so that I can better help you?
After you have filled out this form, please submit and then shoot me a friend request at www.facebook.com/jenniferperduebarter so we can further discuss your goals.
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