Stubborn Heart Kickstart Pre-Registration Form
Please fill out this form with as much detail as possible. It will help me to better understand your needs and what you are hoping to gain from the six week program. There are only 25 spots in the program and additional registrants will be added to a wait-list. Folks willing to make the entire commitment will be given priority. Please contact me at stubbornheartconsulting@gmail.com if you have any questions. Once your form has been reviewed you will be eligible to register online.
If you choose to join this program...We will do it TOGETHER.
What is your first name? *
Your answer
What is your last name? *
Your answer
What is the best phone number to reach you? *
Your answer
What is the email address you would like to receive all program updates during the six weeks? *
Your answer
Please check all boxes for the activities you are fully prepared to commit to: *
Required
Why are you interested in participating in this program? *
Your answer
Do you have previous experience with spin/indoor cycling?
What goal(s) do you have in mind for yourself and/or what would you like to see be different at the end of your six weeks? *
Your answer
What do you think will be your greatest challenge? *
Your answer
In 3-5 sentences please describe the way you think about yourself (ex. body image, self-esteem, character traits etc.) There are no wrong answers here. *
Your answer
Do you have any questions/concerns/comments?
Your answer
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