Name *

First Name

Last Name

Phone *

(###)

###

####

What is your Primary Goal? *

Selecting more then 1 is ok

Peak Performance

Fat Loss

Health and Wellness

Muscle Gain

Other

What is your age range?

18-34

35-40

41-49

50-59

60 +

What is your current level of fitness? *

Starting over again after a long break. I'm a complete beginner

I currently lift weights 2-3x per week and know a little about macronutrients and nutrition.

I've successfully lost weight in the past but gained the weight back

What best describes your current situation? *

I'm skinny and I'd like to put on lean muscle. I have thin arms and legs and some fat in certain areas.

I'd like to lose 10-20lbs of body fat and gain muscle.

I'd like to lose 25lbs or more of fat and I'd like to improve my overall body composition

Travis Focuses on these core principles. Check all that you struggle with. *

The Basics ( confused about all the information out there)

Make time for You (putting yourself first)

Weight Training 3-4x/wk ( learning how to train to build lean muscle)

No food off limits ( knowing what to eat for your body type)

Plan for Progress (consistency)

Correct & Continue ( you fall off track)

How serious are you about making a lifestyle change now? *

Eh, I'm kind of into it but not really ready (1-4)

I'd like to educate myself more about healthy living when I have time. (5-6)

I'm very serious about making my health/fitness a priority now. (7-9)

I'm 100% all in and dedicated to improving my health. Ready to Sign up today!! (10+)