KickStart-HER Bootcamp (2-day Live) Application Form

This is not a registration form.
The Kickstart Her Bootcamp is intentionally kept small to ensure quality guidance and support.
This application helps me assess whether the bootcamp is the right fit for you at this stage.

Name

Age Range

20-29

30-39

40-49

What made you apply for Kickstart Her Bootcamp now?

What do you hope to gain from this experience?

Your current relationship with food:

Confused / overwhelmed

On-and-off dieting

Mostly intuitive but inconsistent

Fairly balanced, want guidance

Your current exercise consistency:

Not exercising

1–2× / week

3+× / week

Your experience level:

Beginner

Exercised before, stopped

Comfortable with basics

This bootcamp focuses on foundations, education, and consistency — not extreme dieting or fast results.Does this align with what you’re looking for?

Yes

Mostly

Not sure

To help me guide you better, which format are you most interested in for Kickstart Her Bootcamp? (*This does not lock you into anything. I’ll review your application and recommend what suits you best.)

Any medical conditions or injuries we should be aware of?

Why do you feel now is the right time to start?

Please acknowledge:

If accepted, I will complete a separate registration & payment form

Form submission[]

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