Application for Transformation Challenge March 31 - May 23, 2019
Please answer the following questions so we can help you reach your goals
Email address *
Your answer
Please fill out the following questions. Once approved, you will receive an email with a link for registration. Program cost is $374 JCC member / $435 non-member. Price includes Nutrition Guide Book. $15 value.
Birth date
Your answer
Your answer
Phone number
Your answer
JCC membership status
We will be using a Closed Facebook Group for this program. Are you a user?
Are you physically active? If yes, describe what you do.
Your answer
Do you prefer to work out alone or in a group?
What are your goals for your transformation?
Your answer
What do you feel are the strengths that will help you achieve these goals?
Your answer
What you feel are the biggest barriers to your transformation?
Your answer
Who will support and encourage you?
Your answer
How motivated are you to make changes to your overall lifestyle?
Rate how confident and motivated you are to implement the following specific changes (5 very confident: 1 not confident at all)
Prep & prepare the majority of your meals at home using recipes we provide
Read and log in a daily journal that you will receive on Day 1 of the program
Follow guidelines for eating out
Read and understand nutrition labels
There will be FOUR meetings with the program's Health Coach to work on nutrition strategies. Will you commit to attending these?
We will be offering workshops with our Holistic Trainer Team for stress management and recovery. Will you commit to attending these?
Which of the following do you consider when preparing meals?
Is there any particular time of day you get food cravings or experience large dips in your energy level?
What do you crave?
Are you aware of any food sensitivities or food allergies you might have?
Your answer
Do you have any medical conditions we should be aware of (i.e. orthopedic concerns, high blood pressure, heart problems*, asthma, etc) * Do you need clearance from your doctor to participate?
Your answer
These are the times of our group training workouts. You may attend any two trainings during the week. Sundays are mandatory for all participants. Check the time slots that work best for your schedule.
Is there any other information you think we should know? Please use this space.
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