Registration for weight-loss challenge

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* 1. Why are you following The ProportionFit Diet & Health Plan (choose up to three answers)?

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* 2. What techniques have you tried (if any) in the past to lose weight (choose as many as apply)?

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* 3. What has been the biggest challenge to lose weight in the past (Choose all that apply)?

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* 4. Which ProportionFit product did you purchase?

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* 5. What is your gender?

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* 6. What is your age?

18 Years 110
i We adjusted the number you entered based on the slider’s scale.

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* 7. What is your most recent measured weight (in pounds)?

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* 8. What is your current waist circumference (optional)?

20 inches 70
i We adjusted the number you entered based on the slider’s scale.

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* 9. How many push-ups can you complete without stopping (optional)?

0 Push-ups 100
i We adjusted the number you entered based on the slider’s scale.

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* 10. How many "chair squats" can you do in 60 seconds (optional)?

0 Chair squats 80
i We adjusted the number you entered based on the slider’s scale.

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* 11. If you win prize money from the challenge, who gets the money (prizes will vary based on placement and number of participants; donations to charity will be made with acknowledgement that you directed the money to that charity)?  Note: You can change your mind later....

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* 12. What is your name and email address (used for tracking purposes only and will not be shared)?

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* 13. In order to qualify for prize money, you will need the following (pictures need not be shared unless you win):
1) A picture showing your starting weight, and another showing your final weight, while you are on the scale
2) A "before" picture of you (ideally a frontal and side view, dressed appropriately for public sharing)
3) An "after" picture at the end of the challenge (similar to above, only better!)
4) A social media posting (posted within a week of starting the challenge and again at the end of the challenge) on Facebook, Twitter, or Instagram sharing that you are starting, and then finishing, the challenge with #IAMProportionFit somewhere in the post. 
5) At the end of the challenge, you will need to share the above pictures with ProportionFit to confirm validity and also for promotional purposes in order to receive the prize money for yourself or charity, should you qualify.

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* 14. I would like to register for the following challenge (may choose more than one):

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* 15. Do you certify that you will follow the principles of ProportionFit for the weight loss challenge (as described in The ProportionFit Diet & Health Plan) and the answers provided here are accurate to the best of your ability?

T