HOLY HABITS APPLICATION

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First and last name* This field is required.

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What is your #1 health goal right now?* This field is required.

Weight loss transformation

Gain muscle

Overall health

Improve my relationship with food

Learn how to lift

Connect my faith to my fitness

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What is your motivation? WHY do you want to hit your desired health goals?* This field is required.

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How would changing your lifestyle affect your life now? And 10 years down the road?* This field is required.how does this affect the people around you? How does it affect your work? etc. What would your life look like if you hit your health goals?

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Be honest, what do you feel is holding you back from being able to reach your desired health goals? (This helps me better understand your situation and prepare for our call)* This field is required.

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what is your age? (*at least 18+)* This field is required.

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Email* This field is required.

example@example.com

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What is your instagram handle? (Ex: @aj_moves__) If no Instagram type "N/A"* This field is required.

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Holy Habits is a high-touch discipleship and coaching program requiring physical, emotional, and financial commitment. It is NOT a cheap one size fits all program. You will build habits through strategic faith based behavior coaching , and gain wisdom on how to steward your health forever, even after the mentorship. Which best describes your personal finances? (Please answer truthfully; this helps us guide you to the best program even if that is not with us - I still want the best for your health and will help you find your next right step!)* This field is required.

I have the financial resources

I have access to financial resources (I can get a loan from affirm for manageable monthly payments)

I do not have financial resources right now

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Will anyone else (e.g. a spouse, family member, etc.) need to be apart of this conversation in order for you to make a confident decision about moving forward, if we both feel its a good fit?* This field is required.

Nope, I'm the sole decision-maker

Yes, my spouse or other family member, friend, needs to be apart of this conversation

Other

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What programs or gyms have you tried before and why didn't it work?* This field is required.

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What happens if you don't change anything?* This field is required.

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How can I pray for you as you take your first steps and start your journey breaking chains with negative health habits?* This field is required.

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Phone Number* This field is required.Area Code + Number

Country Code

Area Code

Phone Number

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Strategy Call With AJ Amrhein* This field is required.This is for women serious about investing in high-level coaching. You will receive a confirmation email immediately after booking. If you do not confirm within 12 hours, your call will be canceled.

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I agree to receive text messages from The Refinery Movement regarding my coaching inquiry, including appointment reminders and follow-ups. Message & data rates may apply. Reply STOP to opt out.

I agree