Livin Proof 365 Pre Registration Form
Please fill out this form in its entirely. This information is used to assist our team in providing a detailed training fit for your current fitness goals. Thank you!
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Email *
Full Name *
Email *
Phone Number *
Age *
1. How did you hear about us? *
Required
2. In a few words please tell me why you’ve chosen Livinproof365? *
3. What is the most you have weighed as an adult? *
5. What is your ideal weight? *
6. What are you hoping to achieve with the help of Livinproof365? *
Required
7. Do you have a specific problem area you would like to improve or tone? If so, describe. *
8. Do you enjoy exercise? *
9. Do you have a gym membership? *
10. Do you have exercise equipment at home? *
11. Do you exercise regularly? *
12. How much experience would you say you have working out? *
Required
13. What type of exercise are you currently involved in (Mark all that apply) *
Required
14. How confident are you that you could increase the amount of exercise you do? *
Required
15. What are your major barriers to increasing that amount of exercise you do? *
Required
16. How much time are you willing to commit to exercise? (min/day) *
17. How often do you/your family eat out? *
Required
18. How often do you cook at home? *
Required
19. Do you portion control what you eat daily? *
Required
20. Do you calorie count? *
Required
21. Do your emotions affect the way you eat? *
Required
22. What are your major barriers when it comes to eating a balanced diet? *
Required
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