LHP X Latinas Unidas Wellness Club
We're excited that you're here! Please fill out this registration form as soon as possible to secure your spot in the club.
Your Name
*
First Name
Last Name
Email
*
example@example.com
Age
*
Did you attend Anita's LEAD Conference session at Harvard University?
*
Yes
No
In which areas would you like to improve? Select all that apply.
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Achieving a physical transformation
Learning about healthier eating and cooking
Increasing my physical activity
Learning to meal prep
Managing my stress better
Getting a better sleep routine
Being more productive
Understanding nutrition and fitness better
Reshaping my mentality around health
Other
If you answered "other", please tell us more.
What is your primary health goal? Select all that apply.
*
Feel better overall
Get stronger
Have more energy
Build self-confidence
Create better daily habits
Lose weight
Gain weight
Maintain current weight
Gain muscle
Other
If you answered "other", please tell us more.
What challenges do you face? Select all that apply.
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Lack of time
Lack of motivation
Lack of energy
Inconsistency with nutrition/fitness
High stress levels
Other
If you answered "other", please tell us more.
Do you regularly prep your meals in advance?
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Yes
No
Sometimes
In your daily eating, do you prefer traditional Hispanic or American foods?
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Hispanic
American
Both
Which movement guide would you like to receive?
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Walking guide
Running guide
Run/walk guide
Would you like to be randomly paired with an accountability partner? Please note: by selecting "yes", your email may be shared with the member you are paired with.
*
Yes
No
Is there a Latina wellness/health/fitness/nutrition expert you would like to see as a guest? If so, please leave their Instagram handle or website below.
Feedback or questions? Use this space to drop us a message!
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