New Customer Registration Form

Client Details:
Full Name*

First NameLast Name
Phone Number*
Age?*
Gender?*

MaleFemaleOther
E-mail*
example@example.com
Preferred contact?

Phone (message or call)EmailInstagram
Instagram Handle
Height
cm
Weight
Kg’s/ lbs
Do you have any existing or past injuries of any kind? If yes, please describe below.
What is your exercise history like? e.g. sport background, casual gym goer etc.
How often do you train? (In and out of the gym)

Once a weekTwice a weekThree times a weekFour times a weekFive times a weekSix times a weekQuite inconsistently
Ideally, how often would you like to/ can you train?
Amount per week
Describe your current diet?
What are your current fitness goals?

StrengthFat/ Weight lossMuscle gainGeneral fitnessNot too sureOther
What are your short term goals? (1 month)
What are your long term goals? (6 months+)
Are you ready to start making changes sooner rather than later?

DefinitelyYesNot sure
What type of service are you interested in?

1 to 1 Personal TrainingOnline training serviceOne off training programOne off Meal plan
Should be Empty:

Client Details: