Full Name
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Phone
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Email
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What are your "fitness" goals?
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Why are you committed to doing this now?
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What is hindering you from achieving your fitness goals?
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Are you willing to make a financial and time commitment on yourself to get in the best shape of your life?
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Yes
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If selected as a client, are you willing to follow your coaches advice for the duration of the program to get the results you are looking for?
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Yes
No
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