Interested in Working with Me?

Before we get started, you must fill out this form. This will help me get to know your current lifestyle and assist me in building the right program for you based off basic information about your health, level of activity, current diet and training regimen. When you press “Submit”, I will be sent a copy of your answers and will be in touch with you shortly.





Athlete Stats:













Health & Medical History:





Nutrition & Exercise


In the spaces below, please provide an overview of your current nutrition and exercise regimen. Please answer these questions honestly so that I may create a plan that is based on factual data. Your results will be a direct reflection of the accurate snapshot that you provide.



Releases
Please read the following carefully. By submitting your electronic signature at the end of this section, you agree to any and all terms and conditions as outlined in this document.

GENERAL RELEASE - I agree to allow PlantBasedMuscles to design a program for me to use as part of my competition preparation. I will not hold PlantBasedMuscles and/or any related persons or parties personally liable for injuries, illnesses or problems that might occur as a result of the program developed for me. This program does not replace the expert advice or medical treatment of a healthcare or medical professional. I affirm that I have provided PlantBasedMuscles with all necessary and pertinent information. I take full responsibility for any and all complications, injuries, illnesses or death that may occur as a result of this program. (If you accept, type initials below)*

REFUND POLICY - By typing your initials below you acknowledge that there is no refund in whole or in part of the initiation fee once paid. (If you accept, type your initials below)*

RELEASE AND HOLD HARMLESS AGREEMENT - I understand that my participation and/or involvement in PlantBasedMuscles carries with it the potential for certain risks, some of which may not be reasonably foreseeable. I further acknowledge that these risks could cause me, or others around me, harm, including, but not limited to, bodily injury, damage to property, emotional distress, or death. I am a willing participant in any and all PlantBasedMuscles activities, events, programs. By signing this agreement, I agree to release, indemnify, and hold harmless PlantBasedMuscles, as well as all its employees, agents, representatives, successors, etc. from all losses, claims, theft, demands, liabilities, causes of action, or expenses, known or unknown, arising out of my participation in any and all PlantBasedMuscles activities, events, programs. (If you accept, type your name as you would sign it below. This is to be considered your E-SIGNATURE)*