Application Form

To Confirm Your application, fill out the form below...

First Name:
Last Name:
Cell Phone:
Email:
Confirm Email:
Gender:
Age:
Height:
Weight:
Body Fat % (if known):
How did you find out about EarthFIT?

Do you have any medical issues, past injuries that would affect training? If no, simply type N/A in the box below.

If you answered yes, do you have clearance from your physician to participate in a regular exercise program?

Do you have any pain or discomfort on your body right now?

When was the last time you exercised at least 2 times a week for at least 3 months?

What did you do in your work outs and why and what was the result?

Can you briefly describe your specific, short-term goals (within the next 8 weeks)?

Can you briefly describe your specific, long-term goals (beyond 16 weeks) with regards to your body and health?

On a scale of 1-10, how serious are you about achieving your goal? (10 is the most serious). If you are not a 10 please explain what is preventing you from being a 10.

What are the best times for you to work out

What is your biggest challenge with trying to lose weight, burn fat, or whatever goal you are looking to achieve? (e.g. eating too much, discipline, motivation, time)

What are some of the problems that your weight or health are causing you?

If you were to reach your ideal goal, what would that do for your life?