Faith, Food & Fitness Accountability Group Application

FAITH, FOOD & FITNESS ACCOUNTABILITY GROUP APPLICATION
Nourishing the Body, Mind and Soul

PLEASE FILL OUT ALL FIELDS TO COMPLETE YOUR APPLICATION.

Your Name

Your Email

Your Phone

Facebook User Name

Do you currently own any Beachbody fitness programs?
No. I do not.Yes. I own one of the following:
P90XInsanity21 Day FixPiYoChalean ExtremeTurbofireBrazil Butt LiftOther (please specify below)

Have you ever tried Shakeology?
I have never tried Shakeology.I have tried it but I am not currently drinking itI currently have Shakeology but do not drink it on a daily basis

I would rank my nutrition as… (1 = eats out for every meal, 5 = cooks healthy/fresh meals at home)
12345

When was the last time you worked out as part of a fitness regimen?
TodayOver a week agoOver a month agoOver a month agoOver a year agoOver 5 years agoI have never tried a fitness program

Do you have any physical limitations?
NoYes. (please specify below)

Briefly explain why you are interested in being a part of this particular accountability group.

What are your goals?
Weight lossMuscle gainGet more definitionHave more energyReduce cholesterolReduce HgbA1C (diabetes marker)Other (please specify below)

How do you feel about the FAITH component being added to your health and fitness journey?

My coach is Heather Reichert (HeatherRD) on TeamBeachbody.com.
YesNo

If no, which best describes you?
I do not have a Team Beachbody coach.I have been assigned a Team Beachbody coach but have not been working with them.I have another Team Beachbody Coach I am currently working with.