Signature Weight Loss Program Application
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First Name *
Last Name *
Email Address *
Where will you be working out? (please note you will need access to at least dumbbells with either choice) *
Do you currently have any medical conditions or injuries? *
What does your current training routine consist of? (Example: Monday - Upper Body,  Tuesday - Lower Body, Wednesday - Rest, ETC.) *
What does your current daily nutrition look like? (Example: Breakfast - egg sandwich, Snacks: Parfait, Lunch: Sandwich, Dinner: steak, salad, potatoes, ETC.) *
How many days per week can you workout? *
Rate this statement on a scale of 1-5  "I am committed to being consistent with training & nutrition for 12 weeks" *
Not Committed
Fully Committed
Rate this statement on a scale of 1-5  "I take full accountability for my own commitment and work ethic towards the Signature Weight Loss Program" *
Disagree
Agree
Rate this statement on a scale of 1-5  "I am ready and committed to putting in the work to creating healthier habits over the next 12 weeks!" *
Disagree
Agree
Which option are you moving forward with in regards to payment? *
I consent and agree that Tstepfitness may use my transformation photos and testimonial on the website and social accounts for the purpose of marketing the Signature Weight Loss Program *
And last but not least, are you ready to change your life?! *
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