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Client entry
First Name
*
Last Name
*
Address
*
City
*
Dropdown
*
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Zip Code
*
Email
Instagram (if applicable)
Program
*
90 Day Body Transformation
30 Days with J
Is this a renewal?
*
Yes
No
Training Start Date
*
Weight
*
Pre-Training Photo Upload
Front
*
Drop a file here or click to upload
Choose File
Maximum file size: 16.78MB
Rear
*
Drop a file here or click to upload
Choose File
Maximum file size: 16.78MB
Side
*
Drop a file here or click to upload
Choose File
Maximum file size: 16.78MB
Meal Plan
*
Basic
Vegan
Pescatarian
Gym Access?
*
Yes
No
Which Gym?
*
If you have any gym equipment, please list:
*
Do you experience any discomfort when jumping?
*
Yes
No
Please list any food allergies:
Past Injuries:
Current Disabilities:
Please list all current medications, vitamins, and supplements:
Food likes
Food dislikes
How many sessions can you commit to completing each week?
*
NOTE: Your answer doesn't automatically determine the amount of sessions you'll be assigned with, this helps with customizing your program.
Extra notes for J Lopez
I've read and accept the 90 Day Transformation Agreement
*
Yes
If you are human, leave this field blank.
Submit
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