Weight Loss Challenge Registration Form

Weight Loss Challenge Registration Form

Three days? Challenge accepted! Fill out the form template and aim to your goal! Form Preview
  • Coach Grant & Nadia

  • 3 Day Weight-Loss Challenge

    Kindly complete this Pre-Registration Form in order to secure your spot in the next Challenge.

  • In order for us to find out what your Goals are, please specify below what you are expecting from this challenge, and why?

  • Dietary Analysis:

    Please could you complete these question in order for me to do a proper dietary analysis. Based on the information provided i will be able to supply you with a meal plan designed just for you. Please be totally honest even if it's KFC 5 times a week.
  • Eg: Junk Food: 3 times a week, KFC - Fully Loaded, Mc Donalds - Big Mc Meal

    Juice: 4 glasses a day

  • How much and how many times per WEEK do you eat/drink the following:

  • What do you normally eat:

  •   Always Sometimes Never
    Have a Healthy Breakfast
    Drink 8 Glasses of Water
    Have 5 Healthy Meals a day
  • Thank you so much.

    Looking forwatd to seeing your amazing results!!

    NOW THAT THE HARD WORK IS DONE

    CLICK THE LINK BELOW TO REGISTER

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