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Take the Challenge!

By completing this form you are on your way to a healthier body and a deeper relationship with God through Jesus Christ!  Congratulations!
(All of your information is strictly confidential).

Contact Information
Name*
Your Age Range*
Address*
City*
State (XX)*
Zip*
Email*
Phone

Physical Information
Height
Weight
Body Fat %
Waist Measurement

Your Physical Goals
Your physical goals are personal and can be anything from "Lose 2 Dress sizes" to "Lose 10 pounds" to "Finish a 10k" or "Exercise 4 times per week". They need to be measurable so that you know when you have had success! (Limit to no more than 3 goals)


 Lose Weight

 Improve Energy

 Sports / Event Performance

 Feel Better / Prevent Illness

 Reduce Stress

 Gain Strength
Tell Us What You
Want to Accomplish!
(Be SPECIFIC)*

Tell Us WHY This
Is Important to You!
Your Spiritual Goals
Your Spiritual Goals should incorporate disciplines that will draw you closer to God through Jesus Christ. Goals may be to "Memorize 1 verse per week" or "Read a chapter a day in the Bible" or "Pray before I get out of bed each morning" or "Lead family devotions each week". It may also be to get in a relationship of accountability. Be as specific as you can be!


 Daily Devotions

 Daily Bible Reading

 Lead Family Devotions

 Serve Others

 Pray To Start The Day

 Other
Tell Us What You
Want to Accomplish!
(Be SPECIFIC)*
Tell Us WHY This
Is Important to You!
Photo Information

 I will submit a before/after photo
If you would like to submit a before and after photo of yourself, please complete this form first. Then, once you submit the form, click the "Submit Your Photo" link on the left of this page.

You Will Receive!

 Free Monthly Fitness eMagazine - articles, videos, nutrition tips, recipies and more

 Free Weekly Training Program

 Free Weekly Inspiration and Motivation from Christian Fitness Experts to encourage you spiritually and physically

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