Programming Intake Form

8-Week Programming Intake Form

Share your details and goals so we can build your custom 8-week workout program
Full Name

First NameLast Name
Email Address
example@example.com
Preferred Contact (Instagram handle or phone number)
Current Training Experience Level
What equipment do you have access to? (Select all that apply)
What is your primary goal?

Something else
How many days per week do you want to train?
Any injuries or physical limitations to program around?
This is general fitness education, not medical advice — consult a doctor before starting if you have health concerns. By checking below, you confirm the info above is accurate, accept the risks of exercise, and release and hold harmless Westin Crosby (a fitness coach, not a medical professional) from any claims arising from this program, and confirm you're 18 or older.
I acknowledge that this 8-week custom program is a $200 one-time investment, paid before the program is delivered.
This only submits your application.

If it's a good fit and space is open, I'll follow up with a payment form after review
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8-Week Programming Intake Form