21 Day Challenge - Initial Questionnaire

21 Day Initial Questionnaire

Name(Required)

First Last

Email Address(Required)

Phone Number(Required)

Please include your country code

Current weight?(Required)

Goal weight?(Required)

Health & Fitness Goals(Required)

Add up to 3 goals - Make sure to include short & long term goals.

What's the biggest thing stopping you from achieving your goals?(Required)

How motivated are you to achieving your goals? Scale 1-10(Required)

1 being - I'm not bothered and 10 being - If I could change right now I would

What are you hoping to get from the challenge?(Required)

NKD TRANSFORMATIONS PTY LTD Waiver & Release Form I, understand that I am choosing to voluntarily engage in an exercise program provided by NKD TRANSFORMATIONS PTY LTD, which may include but not limited to, weight and/or resistance training, cardiovascular training, and/or stretching. I hereby agree to the following: 1. I understand that the results of any fitness program cannot be guaranteed, and that my progress depends on my effort and cooperation in and outside of the sessions. 2. I understand that I have the right to ask questions and receive explanations of exercises, equipment, or any fitness-related matter. 3. I understand that the trainers or employees of NKD TRANSFORMATIONS PTY LTD are not licensed medical care providers and cannot provide medical diagnosis, treatment, or advice. 4. I warrant and represent that I am in good health, and I have no physical or mental condition that would prevent me from participation in the exercise program provided by NKD TRANSFORMATIONS PTY LTD. 5. I acknowledge that participation in the exercise program involves risks, including but not limited to, risk of injury, aggravation of pre-existing conditions, or death. 6. I voluntarily assume all risks associated with participation in the exercise program, and I agree to release and hold harmless NKD TRANSFORMATIONS PTY LTD and its officers, agents, employees, successors, and assigns from any and all claims, liabilities, damages, or causes of action arising out of my participation in the exercise program. 7. I understand that NKD TRANSFORMATIONS PTY LTD may use photos or videos taken during my training sessions for promotional purposes, and I grant NKD TRANSFORMATIONS PTY LTD permission to use my likeness for such purposes. I have read this waiver and release form in its entirety, and I fully understand its contents.(Required)

I agree to all of the above

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21 Day Challenge – Initial Questionnaire

21 Day Initial Questionnaire

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