Please fill out this form only if you have already paid me in person or do not wish to pay online. I would prefer that you pre-pay either online or in person at http://www.gocustomfit.com/payment/buddha-bowl so that I have sufficient money to buy all ingredients. Either way, I need the information below from you regarding your food preferences. Thank you and See you on April 12th at 7pm!!

Name

First Name

Last Name

Email Address

I would like to pay for and prepare:

*No reimbursement if you no shows and no guarantee that I can save your bowl(s). *All bowls will include a grain of sorts unless you have an allergy.

One Veggie Bowl

One Veggie + Chicken Bowl

Two Veggie Bowls

Two Veggie + Two Chicken Bowls

I plan to bring cash or check for the amount of:

2 Bowls $5.00 / 4 Bowls $10.00

$

I am interested in:

Please check all that apply.

Nutrition Assistance

Fitness Training

Goal Setting

Meal Planning

Other