| Name: * |
|
| Date today: * |
|
| OK to publish your story?: * |
|
| What are the TOP TWO REASONS you joined 805 Boot Camp? |
Lose 5 lbs. |
| |
Lose over 10 lbs. |
| |
Lose over 20 lbs. |
| |
Lose over 30 lbs. |
| |
Someone else is making me do this. |
| |
Get RIPPED! |
| |
Sick of the gym. |
| |
Prepare for an upcoming race. |
| |
Get off medications. |
| |
Prepare for a physical test (Law Enforcement/Military/Etc) |
| |
Have more energy. |
| |
Improve my health overall. |
| |
Get stronger. |
| |
Conditioning for special activity (athletic, military, law enforcement, fire, etc) |
| |
Fat loss |
| |
Get into shape. |
| |
Upcoming Event (wedding, reunion, vacation, etc) |
| |
Need a change, I'm already active. |
| |
My doctor ordered it. |
| |
Learn better habits (nutrition & exercise) |
| |
Drop pant or dress size(s). |
| |
Other, please specify. |
| Explain "other" reason for joining us.: |
|
| What best describes the activity you do the most in a work day? |
|
| For "Other" please tell us details.: |
|
| How long had it been since you thought about taking care of yourself as a priority?: |
|
| Was there a life changing/serious reason you are now taking care of yourself as a priority? If so, what was it? (example, diagnosed with a disease or serious malady, heart attack, in an accident).: |
|
| While on our program, what were the most important changes you made to make it successfully through?: |
|
| What would you want to tell someone about this program and your experience?: |
|
| How many inches have you lost?: |
|
| How much weight have you lost?: |
|
| Gender: * |
|
| Age: * |
|
| |
