Challenge Group Application Form

If you would like to be considered for my support and accountability group please fill out the information below. I will respond to you within the next 24 hours.

Challenge Group Application

Name
First Last
Email
Phone
Facebook URL
In 2-3 sentences, tell me a little about yourself?*
Example: Family, Kids, Type of work you do, favorite hobby.
What are your current health & fitness goals?*
Be specific. The more I know the better I can help you.
What are you currently doing for exercise?*
In the past 30 days, can you tell me about your current eating habits?*
What is your biggest hurdle with fitness/nutrition or both?*
What is the one thing you wish to accomplish out of this challenge group?*