First name *

Last name

Email *

Phone

City (Current) *

State (Current)

Date of birth

Social handle

Date of last equipment purchase

Fitness equipment brand of choice *

How many people in your household use fitness equipment? *

Age (Person 1) - Oldest

Age (Person 2)

Age (Person 3)

Age (Person 4) - Youngest

How satisfied are you with your fitness journey? *

Very satisfied
Somewhat satisfied
Neutral
Somewhat dissatisfied
Very dissatisfied

How would you like to share your video? *

VIDEO INSTRUCTIONS: Record a video of yourself sharing the details of your fitness journey. In your video, please explain why you chose to start, where you are on your journey, and what you do to stay committed to fitness and a stronger life? Whether in the gym or in life, share your story of strength and triumph.

Please end all videos with: "I am committed to a stronger life."

Videos should be around 1-5 min in length.

Upload a Video *

Provide a link to your video *

Share any additional details about your journey *

I agree Terms and Conditions

{{text}}, thank you for your entry!

We appreciate you sharing your story with us. Please follow on social and check your email for additional contest updates.

Have a great day!

{{text}}, thank you for your entry!

We appreciate you sharing your story with us. Please follow on social and check your email for additional contest updates.

Have a great day!

Workbench Levergym®