Mom on a Mission (MOM)

$150.00 for 3 months

Mom on a Mission has been designed for women who are busy, but would like to look and feel better, and to be healthy. It has been specifically designed for women who are beginners or intermediate level trainers but have limited time. Each workout can be completed in 20-35 minutes if rest periods are kept to a minimum. This program requires you to have access to a small set of dumbells or weights and/or resistance bands.

WARNING: Only 1 Coaching Services Package or Challenge entry may be added to your basket in a single order. Adding more than one of these items will update your basket to the most recent entry and remove your previous one.

Name*

Surname*

Gender*

Contact Number*

Date of Birth (DD-MM-YYYY)*

Postal Address*

Current Height (cm's)*

Current Weight (KG's / lbs)*

Goal Weight for the next 12 weeks (KG's / lbs)*

Goal Weight Long Term (KG's / lbs)*

Please explain in more detail what you want to achieve now and in the future:*

What best describes your goal for this program? Select option below:*

How many years/months have you been weight training for?*

Do you have any injuries that prevent you from doing certain exercises? If Yes, Please explain further.*

Are you on any medication that we should be made aware of?*

Special dietary requirements (Eg: Vegan or Food Allergies)*

What time do you wake up?*

What time do you go to bed?*

What are your top 3 "healthy meals"?*

What are your top 3 "Not so healthy meals"?*

Program Start Date*

How best would you describe your daily movements / activity level?*

What equipment do you have access to?*

How did you find out about us?*

Referring Persons Name (If Applicable)

I accept the terms & conditions:*

SKU: F-Mom-2020 Categories: Coaching Services, Female Coaching

Mom on a Mission (MOM)

Site Menu Close Menu