Challenge Form – Pure Motivation Fitness

14 DAY FITNESS & HABIT CHALLENGE

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Name(Required)

First Last

Phone [For WhatsApp Accountability Group](Required)

Email(Required)

Gender(Required)

Male

Female

Birthday(Required)

How did they hear about us?(Required)

Member Type(Required)

EXERCISE: Add Check Box For:(Required)

I have no equipment and prefer bodyweight training

I don’t have a gym, but I have dumbbells at home

I have a gym membership and want to train there

I live in Vaughan and want to train at Pure Motivation Fitness

Fitness Goals (Select One)(Required)

I want to lose 15-20 pounds, get leaner, and achieve a more defined body shape.

I want to gain 10-15 pounds of muscle and increase my overall size and strength.