FitTastic Health Wellness Workshops & Workouts 
Welcome to the FitTastic Health Wellness Workshops & Workouts registration page!

We're happy you're registering with us!

Together, let's have a super FitTastic time as we work together to encourage and inspire each other towards greater health and wellness.

Please complete the below survey to help us learn about your needs and interests.  We want you to have a great experience, but we first need to gather a bit of information about you. Please answer honestly to the best of your ability. It will help us to know the best way to serve you.  

Thank you very much for your time and input.

We're really looking forward to delivering a Super FitTastic and memorable event for you! 

Let's do this!
Quiana Canfor-Dumas 
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Email *
Name *
City *
State/Region *
Country *
Age *
Male/Female *
Height *
Weight *
Race/Ethnicity *
What's your goal?  Why do you want to participate in this Workshop & Workout event? *
Do you want to lose weight? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to add muscle? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to look and feel better? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to learn how to stay consistent? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to learn how to gain more energy and vitality? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to learn how to get off medications? How important is it to you? (Rate importance from 1-10) *
Do you want to learn how to get control of your eating? If so, how important is it to you? (Rate importance from 1-10) *
Do you want to maintain your weight, performance, and/or habits after achieving your goal? If so, how important is it to you? (Rate importance from 1-10) *
If you had to choose between the following 4 goals, which one is most important to you? *
How READY are you to make the necessary changes to improve your overall wellness? *
How WILLING are you to make the necessary changes to improve your overall wellness? *
How ABLE are you to make the necessary changes to improve your overall wellness? *
Do you currently have an injury or movement limitation, or pain that limits your ability to exercise? *
If you answered yes to the above question, do you think you'd benefit most from following:
What is your greatest exercise challenge? *
What's your biggest nutritional challenge? *
Required
How many of your meals are prepared at home each day?   *
What is your preferred eating style? *
How many meals would you like to eat each day?
How much do you want to weigh (lbs/Kgs)?
On average, how many glasses of water do you drink each day? *
On average, how many of your meals include at least one palm-sized portion of protein (like meat, fish, dairy, eggs, or any other protein dense plant foods)? *
On average, how many of your meals include at least one serving of colorfull fruit or vegetable.? *
On a scale of 1-10, how knowledgeable are you now about making smart food choices? *
What best describes your weekly workouts: *
How many hours a week do you do some form of aerobic or cardio-type training (jogging, brisk walking, cycling, boxing, swimming, etc)? *
How many hours a week do you do some form of resistance training (lifting weights, body building, power lifting, etc) *
How many hours a week do you do some form of intense conditioning or anaerobic interval-type work (sprinting, crossfit, HIIT, wrestling, etc)? *
How many hours a week do you do some form of low-intensity movement (gentle walking, yoga, golf, Aquafit, etc)? *
Do you have a diagnosed health condition? *
If you have a diagnosed health condition, what is it?
Do you currently work with a holistic nutritionist, registered dietician, naturopathic doctor or other nutritional practitioner or specialist? *
Do you currently work with a personal fitness trainer or other exercise specialist? *
What is your biggest exercise challenge? *
Required
Do you wear an activity tracker?  Something to track your steps? If so, what? *
Would you like to join 30 Minute LIVE YouTube Workouts? *
Do you wear a rate monitor to track your exercise intensity? If so, what? *
On average, how many hours of sleep do you get each night?
Do you track your hours of sleep and sleep quality?  If so how? *
How often do you drink alcohol? *
How often do you smoke cigarettes? *
Are you a primary caregiver for children, individuals with a disability, or an elderly relative? *
What is your typical stress level at home? *
For all your lifestyle-related stressors, how well do you cope with stress? *
What time of day do you primarily work? *
How many hours do you work on most days? *
What's your activity level at work? *
What is your typical stress level at work? *
How often do you travel for work? *
 Did you overcome a major health challenge?  Did you make various lifestyle that led to better overall health? We would like to feature some Wellness Success Stories during the Workshop & Workout event.  Do you have a Wellness Success Story you'd like to share?  You can type your story in the space below.  You can also send a short video.  Your story can be great source of inspiration to others.   Please consider sharing.
Do you have any suggestions or recommendations for the Workshop & Workout event?  Are there any specific workshop topics you'd like to have?  Please share.  We'll be happy to include your input as we create the plans for future events.
What's your favorite inspirational song? It can be a fast and/or slow song. Please share the name and artists. *
I understand that the information I provided is strictly confidential and it will be used to help create the best health and fitness workshop & workout.  My data will be used mostly in aggregate form — in other words, to focus on and analyze the overall population of the community, rather than single specific individuals.  My data will help with the development and implementation of a health & fitness workshop & workout that benefits the participants. *
The goal of the FitTastic Health Workshop & Workout is to help everyone to get and stay healthy. We still need to be sure that you take full responsibility for your health and the monitoring of it.  It is important to understand:  1.  Our advice cannot replace the advice of a trained medical doctor.  2.  If you choose to participate in the FitTastic Health Community without the prior consent of your physician, you agree to accept full responsibility for your decisions and to hold harmless FitTastic Health, its agents, officers, and employers and any affiliated companies from any liability with respect to injury to you or your property arising out of or connected with your use of the information discussed. *
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