Tell Me About Yourself
Please complete this form so I can connect with you and send you more details for our Interactive Fitness that is great for all fitness levels this Fall!  If you like quick and effective workouts, this may be for you!  You don't have to be perfect. You just have to START!  :)

As soon as you register here, I'll get more info sent out to you along with a sample workout to try as well if you want!  
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Email *
Hello! I'm Jackie Kent.  I've been a Personal Trainer and Online Fitness Coach for 8 years!
I'm looking forward to connecting with you!
First Name *
Last Name *
What's your Facebook or IG Profile URL?
*(copy/paste the url link from your profile page. Ex: www.facebook.com/jackie.d.kent)




Please tell me a little about your goals?    Do you want to lose weight (if so, how much), tone up, eat better, gain more energy, improve your self-confidence, etc.? *
What types of exercise do you enjoy? Please check all that apply! *
Required
How is your nutrition? *
Do you eat breakfast and if so, what is your usual? *
How much time can you commit to home workouts? *
Required
How would you rate your current fitness level? *
What kind of fitness would you prefer *
How is your sleep at night? *
Do you have energy throughout the day or are you surviving on coffee to get you by? *
Are you in: *
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