- BC Survey

Fill Out the survey below! You will be surprised how affordable Boot Camp really is!

Your Name: *

Your Email: *

Subject:

Phone #

1. How much television did I watch in the last week? *

Is this typical? If so, what is this amount X 10 *

How much do I spend on cable or dish network in a month? *

2. How much money did I spend on fast food this past week? *

Is this typical? How much does this equate to in 10 weeks? *

3. How much did I spend eating at restaurants last week? *

In the last 10 weeks? *

4. How much money did I spend yesterday on junk food such as frozen pizza’s, TV dinners, candy bars, potato chips, soft drinks, ice cream, etc? *

last week? In the last 10 weeks? *

5. How much did I spend on espresso’s, latte’s or coffee yesterday? *

last week? The last 10 weeks? *

6. How much did I spend on cigarettes yesterday? *

Last week? In the last 10 weeks? *

7. How much did I spend on beer, wine or other forms of alcohol yesterday? *

Last week? In the last 10 weeks? *

8. How much did I spend on illegal drugs yesterday? *

last week? In the last 10 weeks? *

9. How much did I spend on diet aids last week? In the last 10 weeks? *

10. How much time and money did I spend at a casino last week? *

In the last 10 weeks? *

11. How much time and money did I spend at bars or taverns last week? *

In the past 10 weeks? *

12. What do I spend in terms of time and money on material possessions or activities which could probably be better spent elsewhere that may benefit myself and family more? For some people this may mean monthly car payments on a car that may boost our ego but where we could get by on something less ostentatious. For others it may mean working on personal projects or activities that could be spent elsewhere that would have a better benefit to ourselves and families. *

13. Now how much extra work do I have to put into my work at my job or business to be able to afford these “extras”? *

14. How much does all of this add up to in a 10 week period of time in terms of time and money? *

15. How about multiplying this by 5 and determining costs for a year. Multiply any of these above 10 week numbers by 100 and determine what the total costs will be in the next 20 years. *

Medical costs related to health & appearance:

1. In the past 5 years how much have I spent on weight loss surgery? *

2. In the past 5 years how much have I spent on cosmetic surgery? *

3. In the past 10 weeks, what have I spent on medications for health related issues that are caused or exasperated because of my diet or lack of fitness? *

4. In the past 10 weeks how much have I spent on anti-depressant medications? *

5. If I have gone to the extent of determining what the costs are of the procedures mentioned in questions 1 and 2, what would the cost likely to be in the next 5 to 10 years if I opted for medical options to try to solve fitness, or physical appearance issues? *

Self satisfaction with fitness level and appearance:

1. On a scale of 1 to 10 (1 being the worst and 10 being the best), where am I at in terms of satisfaction with my appearance? *

2. On a scale of 1 to 10, where am I at in terms of satisfaction with my weight? *

3. On a scale of 1 to 10, where am I at in terms of satisfaction with my level of fitness ? *

4. On a scale of 1 to 10 where am I at with my productivity level at work or in my business? *

5. On a scale of 1 to 10, where am I at in terms of satisfaction with my ability to be involved with high energy activities with my family and friends? *

6. If I were to be honest with myself for a moment what would I say I feel emotionally on an ongoing basis about my answer to the above questions? *

We will then allow ourselves to get a glimpse of where we would like to be. This is an opportunity to dream big (or small) We can imagine looking at ourselves in the mirror and admiring our physical appearance. We can be proud of the hard work it takes to get physically fit without having to be vain about it. Imagine how it would be if people are complimenting the changes we have made. More importantly, imagine how our life will be if we feel better physically and emotionally? Imagine having more energy to spend with your family and doing fun and healthy activities. Imagine what it will be like to increase your output at work or in your business. How much could that calculate in terms of promotions at work, or increased income in your business? When you feel better about yourself other people are drawn to you more and this can also bring more success into your life or increase your ability to positively influence others.

1. On a scale of 1 to 10, where would I like to be in terms of satisfaction with my appearance? *

2. On a scale of 1 to 10, where would I like to be in terms of satisfaction with my weight *

3. On a scale of 1 to 10, where would I like to be in terms of satisfaction with my level of fitness? *

4. On a scale of 1 to 10 where would I like to be in terms of the amount of energy I would like to be able to devote during my work hours at my job or in my business? *

5. On a scale of 1 to 10, where would I like to be in terms of satisfaction with my ability to be involved with high energy activities with my family and friends? *

6. If you first took a look at how much TIME you spend on unhealthy or non-productive activity, How much time and effort would you be WILLING TO SPEND to make the above five answers a “10”. *

7. If you were to take a look at how money is spent in an unhealthy way, what would it be worth to you to spend in a 10 week period of time to look and feel great, be more productive in your work, and to be more available and to set an excellent example to family and loved ones? *

Making objective goals for ourselves:

What do I weigh now? *

What would I like to weigh in 10 weeks? *

What would I like to weigh in one year? *

What is my percentage of body fat? *

What would I like it to be in 10 weeks? *

What would I like it to be in a year? *

How far can I walk or run? *

How far would I like to be able to walk or run in 10 weeks? *

How far would I like to be able to walk or run in a year? *

How long does it take me to walk or run a mile? *

What would I like that time to be in 10 weeks? *

What would I like it to be in a year? *

How many sit-ups can I do in 2 minutes? *

How many would I like to be able to do in 10 weeks? *

How many would I like to be able to do in a year? *

How many push-ups can I do in 2 minutes? *

How many would I like to be able to do in 10 weeks? *

How many would I like to be able to do in a year? *