First Name

Phone *

Email *

Do you have a partner or need us to assign you one?

What motivated you to check out the challenge

Weight Loss

Fitness

Cancer Prevention

Support Charity

Are you most interested in:

Remote Program

In Person

Still Deciding

What’s the best way to reach you?

Phone call

Text message

Email

When is the best time for us to connect?

Morning (8–11 AM)

Afternoon (12–4 PM)

Evening (5–8 PM)

How ready do you feel to commit to a 91-day program?

Very ready

Somewhat ready

Just curious for now

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