8 week Rower Fitness & Nutrition Casting
8 week fitness & nutrition program for weight loss. Results may air on TV and social media. This form will not be made public, but will be used internally in the casting process.
Full Name *
Phone *
Email (check typing for accuracy) *
Occupation *
Relationship Status *
Do you have kids? If yes, kids ages
Current Age *
Height *
Current Weight (if you don't know take your best guess) *
Goal Weight *
Check all that apply *
List all current medications and supplements taking *
What is motivating you to want to lose weight and do you have additional goals beyond weight? *
Are there things in life you avoid doing because of your weight? (please be specific) *
Who in your life would be most supportive of your weight loss journey? *
Do you have any current fitness regimen? If so, please elaborate.
Have you ever used a rower?
List your top 2-3 "vices" you would like to improve
How would you describe your current eating?
Anything else you would like to share?
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