Toggle navigation
What is Lose to Win?
Kiosk Locations
Privacy
Enrollment - JOIN FOR FREE
Please wait while the data is being Loading / Updating.
Personal Profile
16
Select Height
4 Feet 1 Inch
4 Feet 2 Inches
4 Feet 3 Inches
4 Feet 4 Inches
4 Feet 5 Inches
4 Feet 6 Inches
4 Feet 7 Inches
4 Feet 8 Inches
4 Feet 9 Inches
4 Feet 10 Inches
4 Feet 11 Inches
5 Feet
5 Feet 1 Inch
5 Feet 2 Inches
5 Feet 3 Inches
5 Feet 4 Inches
5 Feet 5 Inches
5 Feet 6 Inches
5 Feet 7 Inches
5 Feet 8 Inches
5 Feet 9 Inches
5 Feet 10 Inches
5 Feet 11 Inches
6 Feet
6 Feet 1 Inch
6 Feet 2 Inches
6 Feet 3 Inches
6 Feet 4 Inches
6 Feet 5 Inches
6 Feet 6 Inches
6 Feet 7 Inches
6 Feet 8 Inches
6 Feet 9 Inches
6 Feet 10 Inches
6 Feet 11 Inches
7 Feet
7 Feet 1 Inch
7 Feet 2 Inches
Gender:
*
Male
Female
Ethnicity:
*
Hispanic Origin
Non-Hispanic Origin
Refuse to answer
Race:
*
Caucasian
African American
Asian
Native American
Other
Refuse to answer
How did you hear about us:
Employee ID:
Select District:
Select Location:
I AGREE: Please check the box after reviewing our
User Agreement
&
Privacy Policy
Contact
Select State
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District Of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Mobile Number:
*
Receive Text/SMS Coaching?
*
Yes
No
Coaching
Meal preference:
*
Standard
Gluten Free
Vegetarian
Vegetarian Gluten Free
Fitness program:
Select Fitness Program
Foundation
Intermediate
Advanced
Equipment:
Select Equipment
Home
Gym
Language preference?
*
English
Spanish
Are you physically able to stand on a scale:
*
Yes
No
Would you like team challenge info?:
*
Yes
No
Fitness Goals:
*
Barriers
If none of the above options apply, please explain briefly what motivated you to join this program.
Motivation
If none of the above options apply, please explain briefly what motivated you to join this program.