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6 women contact form
LaurenCharlotteFitness
2020-12-14T23:44:58+00:00
ARE YOU READY FOR CHANGE?
I am looking for women located in Milton Keynes who may have had issues in the past with one or more of the following: dieting, exercise, their relationship with their body or with food, self esteem or perfectionism. I want to offer 2 of these women the chance to receive 2 weeks free personal training and nutrition advice plus ongoing support worth over £200 in order to help them kick start their transformation and grow in confidence! Please fill out the questionnaire below to be considered.
Name
*
E-mail
*
Contact Number
*
How old are you?
*
18 to 24
25 to 34
35 to 44
45 to 54
55 to 64
65 +
Please briefly detail what your average day looks like in relation to activity and movement?
*
Please briefly detail what an average day looks like in relation to what you eat
*
On a scale from 0-10, how confident are you in yourself as a person?
0- Not confident at all
1
2
3
4
5
6
7
8
9
10- Extremely Confident
On a scale from 0-10, how confident are you with your body?
0- Not confident at all
1
2
3
4
5
6
7
8
9
10- Extremely Confident
I would like to be contacted about future offers or deals from LC Fitness
Yes
No
Email
Submit
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