The purpose of this application for our 7 day challenge is to help you get started towards achieving your fitness goals. We will review this form to make sure you are a great fit for this challenge!

Name

First Name

Last Name

Email Address

Phone

(###)

###

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What are your health and fitness goals, exactly?

On a scale of 1 to 5 how serious are you in reaching these goals? (1 being not important at all and 5 being it is one of the most important goals for me to reach)

Why do you want to do this challenge?

Are you ready to do whatever it takes to reach your goals in the next 7 days?