Let’s get to know one another!

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What is your “Why?”

Please answer the questions below in as much detail as possible. This will allow me to gain a better understanding of your top priorities, goals and concerns. Upon submitting, I will be in touch regarding next steps. Thank you, and congratulations on taking this important step towards being your most confident, beautiful, bada** you!
Name *
Name
Date of Birth *
Date of Birth
Which of the following are priorities to you? *
What obstacles and challenges have you faced in the past that kept you from achieving your goals? Check all that apply. *
By submitting this form, I acknowledge that the I take full responsibility for my life and well being, as well as the lives and well being of the my family and all decisions made during and after this Program. I expressly assume the risks of the Health and Fitness Program, including the risks of making nutrition, lifestyle and fitness changes. I release the Coach and Personal Trainer from any and all liability, damages, causes of action, allegations, suits, sums of money, claims and demands whatsoever, in law or equity, which I ever had, now have or will have in the future against the Coach, arising from my past or future participation in, or otherwise with respect to, the Health and Fitness Program, unless arising from the gross negligence of the Coach. I, the Coach, will keep the Client's information private, and will not share the Client’s information to any third party. -Sally Willoughby
HOORAY! Let's do this!
Thank you for taking the time to fill out this information. Remember, all of your answers will remain confidential. I will be in touch shortly with next steps and further details!

Thank you - you rock!