1on1 Crushin' Goals Program Application

Crushin' Your Goals

with certified Coach Amy Gaskin
Name*

First NameLast Name
Age*
State & Time Zone*
Email*
example@example.com
Phone Number*
Please enter a valid phone number.Format: (000) 000-0000.
You will schedule a free 15 minute discovery call after submitting this form. If we are a good fit, a $100 non-refundable deposit is required to hold your spot for the next session. The deposit will be applied towards your coaching fee. Do you agree? *
Do you understand that this 7 week 1on1 program is $374? Payment is due by the beginning of the session. You may pay via apple pay, credit or debit card upon registration.*
Do you understand that a solid understanding of the the Trim Healthy Plan is required. This is not a session that will include THM education or food review.*
If you have ever completed my Buds Group Coaching Program, which session was it? *
What are your goals?*
What led you to seek out a coach?*
Are you willing to learn, take my suggestions and possibly change habits to reach your goals?*
What do you need help with the most?*
How did you find me and/or did anyone recommend me to you?*
Upon submission, you will be redirected to book a •required• free 15 minute discovery video call with me to be sure we are a good fit. In addition, an email with the booking feature and confirmation of this form will be sent from this email address: noreply@jotform.com as a back-up. Please check spam/junk. Do you agree?*
Signature

Clear
Should be Empty:

Crushin' Your Goals