Synergy Training Solutions Teen Transformation Program

Team Synergy is now taking applications for our NEXT TEEN TRANSFORMATION! The problem of childhood obesity in the United States has grown considerably in recent years. According to the American Academy of Child and Adolescent Psychology; between 16 and 33 percent of children and adolescents are obese. Unhealthy weight gain due to poor diet and lack of exercise is responsible for over 300,000 deaths each year. Overweight children are much more likely to become overweight adults unless they adopt and maintain healthier patterns of eating and exercise. Its time for us to rally together to slow this trend in our own community! Through the Teen Transformation Program, our personal trainers work with community members to identify and support a local teen. HOW do we accomplish this task? Fitness and nutrition counseling from certified personal trainers One on one fitness sessions each month with certified personal trainers Short and long term goal setting guidance and support Support from their very own personal trainer AND friend

Being overweight or obese is not only a tax on teens physical health, but also results in lower self confidence, decreased focus on academics and challenges with lifestyle. Lets work together to help one lucky area teen take charge of their life through health and fitness! The first teen transformation: Our initial participant committed to twice monthly training sessions, worked to improve her nutrition in a variety of challenging situations (school, out with friends, etc.) and even began moving more on her own through strength and cardio training. At just the halfway point, she had already lost 10 pounds! We will be confirming final results this week, and are excited to keep this program in place for the next participant. To the friends of Synergy and DVWMTS; now it is time for the next participant to reap the rewards of this program. Please distribute the application below to those eligible for the program. Deadlines include: Application Deadline: 5/5 Selection of the Participants: 5/14 Initial Consultation between Synergy and Participant: 5/21 First Training Session: Week of 5/30 THIS IS A 6 MONTH PROGRESSIVE PROGRAM. APPLICANTS MUST BE EXPECTED TO CONSISTENTLY PARTICIPATE FOR THE DURATION OF THE PROGRAM; 6/1 12/1. Please feel free to contact me with any questions via allyn@synergytrainingsolutions.com. In good health,

Allyn Amelia Blind, M.S., NASM-CPT

www.synergytrainingsolutions.com E. allyn@synergytrainingsolutions.com, P. 724.355.0755

Application
Deadline: May 5, 2012 Program Participant Eligibility: - 14-17 years old - Must currently maintain 3.25 GPA or higher - Complete application in its entirety --------------------------------------------------------------------------------------------------------------------------------General Information: Name: Birthday: M/F:

School: Family Members in Household: --------------------------------------------------------------------------------------------------------------------------------General Health History/Information: Current Weight: Current Height: Desired Weight:

Are you aware of any current health conditions? Y/N If so, please explain:

Does your family have any known history of serious health problems and/or disease? If so, please explain:

Y/N

How many days per week do you exercise? What types of exercise do you participate in?

What is a typical day of nutrition (diet) for you? Breakfast: Snack: Lunch: Snack: Dinner: Other: --------------------------------------------------------------------------------------------------------------------------------Interests and Hobbies: What is your favorite subject at school, and why?

www.synergytrainingsolutions.com E. allyn@synergytrainingsolutions.com, P. 724.355.0755

What is your favorite hobby outside of school, and why? Page 1 of 2

What would a weight loss program mean to you?

How many days/week can you commit to your health and fitness? What are some potential obstacles that you can see that may challenge you?

What types of support do you look to receive from your family and friends?

What types of support do you look to receive from your personal trainer(s)?

Do you have access to any exercise equipment?

ESSAY: Please answer the following question in 3-4 paragraphs (use additional paper if necessary). What does HEALTH mean to you?

www.synergytrainingsolutions.com E. allyn@synergytrainingsolutions.com, P. 724.355.0755

Please submit to:

Allyn A Blind 5904 9th St. NW Apt. 4 Washington DC 20011

OR

allyn@synergytrainingsolutions.com

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www.synergytrainingsolutions.com E. allyn@synergytrainingsolutions.com, P. 724.355.0755