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Basic Membership / 2021 Winter Challenge Form

Before you begin, please note that you must be 18 years old or older.


You should consult your physician or other health care professional before starting this or any other weight loss program to determine if it is right for your needs.


This form is ONLY for clients who have purchased the basic GGT Lifeline membership.

GENERAL INFO

*First Name
*Last Name
*NOTE: FIRST NAME, LAST NAME, AND EMAIL MUST MATCH YOUR PURCHASE ORDER.
*Phone
City
*Sex

Age

*Age

Birthdate

*Birthdate

Height

Weight

*Current WeightIndicate Pounds or Kilograms
*Goal WeightIndicate Pounds or Kilograms
Rate of Weight Loss*:
Other
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*Please note that the nutrition team will assess whether or not this is safe for you. Calorie deficit may be adjusted to ensure a safe calorie level


**If your goal weight is significantly LESS than your current weight, this option may not be right for you.



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THIS OPTION IS ONLY FOR CLIENTS WHO HAVE PURCHASED THEIR ADMISSION FEE FOR OUR 2021 8-WEEK WINTER CHALLENGE.

*Do you want home or gym workouts? (choose one)


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ACTIVITY FACTOR

*How many days a week are you planning on working out?
*Select which best describes your level of activity outside of working out:

ADDITIONAL INFO

*Have you ever been diagnosed with any hormonal issues?

*Are you pregnant or breastfeeding?
If breastfeeding, approx. how many ounces do you lactate per day?
If pregnant, how far along are you?
*What style of macros works best for you?
Other
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BODY TYPE

If you do not know your body type, ATTACH 1 to 3 images: Front, Back and/or Side. (Preferably front and back). To be in either a bikini or a sports bra and shorts.

Uploads
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For a free body type assessments please email bodytype@gaugegirltraining.com

ACKNOWLEDGEMENT: Yes, I have reviewed my answers and understand that the program CANNOT be re-adjusted to accommodate for changes after hitting "SUBMIT."
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