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Home | Yoga Programs & Retreats | BootCamp | BootCamp Questionnaire

BootCamp Questionnaire

Thank you for your interest in BootCamp. Please take a couple of minutes to complete this questionnaire so we can get to know you a little better. One of the program leads will follow-up with you soon!

Questions with asterisks * are required.

Name:

Email Address:

Confirm Email Address:*

Phone:*

What goals do you hope to achieve during BootCamp? Please choose all that apply.
Lose weight
Nutrition education
Stronger yoga practice
Increase athletic strength
New cardiovascular workouts
More muscle tone/sculpted muscles
Other:

Please Elaborate

Weight Amount
5 lbs
5 - 10 lbs
10 - 15 lbs
15+ lbs

Tell us a little bit about your current activity level
Running
Cardio machines at the gym: (elliptical, stairmaster, stationary bike, etc.)
Weight Lifting
Aerobic exercise: (kick-boxing, step classes, etc.)
Low impact workouts
Outdoor sports
Sports

Times per week

Weekly Mileage

Times per week

Length of time on machine per visit

At home
At gym

Times per week

At home
At gym

Times per week

Walking
Other:

Times per week

Please Elaborate

Skiing
Hiking
Swimming
Surfing
Cycling
Other: