Information Form
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Email address *
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Name: *
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Age: *
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Which service are you most interested in? *
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Weight: *
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Height: *
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On a scale of 1 - 10, how would you rate your overall fitness? *
mashed potato on a couch
Batman idolizes Me
What are your goals? (check all that apply) *
Is this a new goal? (an active pursuit of 6 months or less) *
What worked well for you in the past that helped you get closer to your goals?
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Have you worked with a Trainer Before? *
Please tell me a bit about what you're currently eating and drinking...
Are you currently doing anything specific with your diet or nutrition? If so what type of program are you following?
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How long do you imagine it will take to achieve your fitness goal? *
On a scale from 1 - 10, how committed are you to getting results? *
I'm not
Armageddon wouldn't stop me!
What conflicts are currently preventing you from achieving your goals?
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By undertaking training I understand that inherent injury risks are involved when performing physical activities even when performed under the guidance of a professional instructor. I take full responsibility for my personal safety and any injuries I may incur. *
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