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KB KUTS Application
1
To confirm, you're filling this out because you want to lose fat, build muscle, and optimize your health while finding a permanent solution to living a healthier lifestyle?
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Yes — I’m serious and ready to explore coaching.
No — I’m not ready to commit yet.
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2
Full Name
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First Name
Last Name
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3
Email Address
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example@example.com
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4
Phone Number
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Please enter a valid phone number.
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5
What’s the biggest thing holding you back right now?
(select all that apply)
Inconsistency
Nutrition confusion
No accountability
Low energy / burnout
Tried everything, no results
Other
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6
In your own words, what’s been most frustrating about this?
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Example: “I’m struggling to lose belly fat” or “I’ve been working out but not seeing results.”
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7
What is your #1 fitness goal over the next 90 days?
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Example: “Lose 20 pounds, feel stronger, and fit into my old clothes.”
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8
What is holding you back from reaching that goal?
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(Select all that apply)
I’m not sure what workouts to do
I don’t know how to eat for fat loss and muscle
I’ve struggled with consistency
I don’t have accountability or coaching
I’ve tried programs before and didn’t stick with them
Other
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9
What have you tried before to lose weight or get in shape?
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(Select all that apply)
Dieting (Keto, Fasting, Low-Carb, etc.)
Group classes or bootcamps
Personal training
Online workouts (YouTube, apps)
Doing it on my own
Nothing — this is my first time seriously trying
Other
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10
On a scale of 1-10, how committed are you to transforming your body and life right now?
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(1 = not ready, 10 = all in)
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11
Why is now the right time for you to take action and make this change?
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12
If accepted, are you prepared to invest in coaching at
$300–$400 per month
for a 16-week program, with payment options available?
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Yes — that works for me
Yes — but I’d need payment options
No — not at this time
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13
How soon are you looking to get started?
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Within the next 2 weeks
Within the next 30 days
Not sure yet
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14
Do you currently have kettlebells or access to workout equipment?
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Yes, I have kettlebells at home
No, but I’m willing to get some
No, and I’m not sure what to get
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15
Do you have any injuries or limitations we should know about?
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16
Anything else you want us to know about you or your goals
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17
By submitting this form, I understand this is a high-level coaching program and requires commitment to achieve results.
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Yes, I understand and agree.
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