Hybrid Lifestyle Online Training Interest Form

Online Training Interest Form

Complete this form to the best of your ability, and Coach Donte' will reach out to you to soon.
Name*

First NameLast Name
Email*
example@example.com
Phone Number
Please enter a valid phone number.
Age
Gender

FemaleMale
Fitness Questionnaire
Are you able to perform basic exercise movements? (Ex. Lunge, Squat, Press, Jump etc.?)*

YesNoOther
If you chose no or other, please explain your limitations
Where will you primarily be working out at?*

Fitness GymAt Home with EquipmentOther
What Fitness Equipment Would You Like Included In Your Program?*

DumbbellsBarbellKettlebellsStrength MachinesTreadmillResistance BandsBattle RopesTRXBosu BallStability BallOther
Do you enjoy Strength Circuit/HIIT style of training?*

YesNoI'm not sure, but I'm down to try it.
Preferred Length of Workouts?*

30 Minutes45 Minutes60 Minutes
What are your Fitness Goals?*

Improve StrengthLose WeightBurn FatBuild MuscleImprove Athletic AbilityImprove EnduranceOther
What are your biggest struggles when it comes to fitness?*

I do not know where to start.I have a hard time staying motivated.I exercise regularly, but do not get the results I want.Other
How many times per week are you currently working out?(Weight lifting,Cardio, Yoga etc)

None at allAt least 1x per weekAt least 3x per weekMore than 3x per week
Lifestyle Questionnaire
On a scale 1-10, how physically active are you at work?*

1

2

3

4

5

6

7

8

9

10

1 is Not Active at All, 10 is Very Active
How stressful is work?*

Not Stressful At AllModerately StressfulVery Stressful
On a scale from 1-10, what are your energy levels throughout the day? *

1

2

3

4

5

6

7

8

9

10

1 is Low Energy, 10 is High Energy
What's your biggest stress factor?*

WorkSchoolMoneyFamilyFitness/HealthOther
On a scale from 1-10, how good are you nutritional habits? *

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2

3

4

5

6

7

8

9

10

1 is Not Good, 10 is Extremely Good
What are your biggest nutritional struggles?*

Don't Know What to EatOvereating/Binge EatingEating Enough Fruits and VeggiesPlanning MealsToo Much SnackingSkipping Meals (Breakfast, Lunch or Dinner)Bad Eating Habits on the WeekendsToo Much Alcohol/WineOther
How much soda or juice do you drink per day? (Note: There are 1.5 cans of soda in a 20oz bottle)*

I only drink water1-3 cans of soda/juice per day4-7 cans of soda/juice per dayMore than 8 cans of soda per day
How many times do you eat fast food a week?*

0-2 times a week3-5 times a weekMore than 5 times a week
Final Questions
What is your main reason for wanting to join Hybrid Lifestyle Online Training?*
How serious are you about achieving your fitness goals?*

1

2

3

4

5

1 is Not Serious At All, 5 is Extremely Serious
Which program are you most interested in?*

28 Day Jumpstart Challenge90 Day Transformation Challenge
How much money are you willing to invest to improve your health and fitness?*

$0$125+Whatever the program costs!
Should be Empty:

Online Training Interest Form

Fitness Questionnaire

Lifestyle Questionnaire

Final Questions