Application for Mad Tuf Fitness
First and last name
*
Gender
*
Female
Prefer not to say
Email
*
Address
*
What is your date of birth
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-
Month
-
Day
Year
Date Picker Icon
What is your height? (feet)
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What is your current weight? (lbs)
*
What are your specific goals? (Select all that apply)
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Increased Strength
Weight-gain
Improved endurance
Fat loss
Improved Health/ Mental Health
Increased muscle mass
How active are you?
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Very active (5 days+ / week)
active (3-4 days/week)
somewhat active (2-3 days/week)
not active (1 day or less/week)
What do you do for work?
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What program are you interested in?
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1:1 Personal training
Un-coached training program
Have you ever done weight training before?
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yes
no
What do you like doing in your spare time?
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Do you have any injuries? If so, please list them
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If you have any diagnosed health list the condition(s).
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If answered "yes" to above question, has your doctor given you the "okay" to start a fitness program?
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Yes
No
N/A
What program are you looking for?
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home workout
gym workout
Do you have a history of an eating disorder?
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Yes
No
I agree I am over the age of 18 years of age.
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Agree
I understand that my trainer is not a medical professional and cannot replace the advice of one. I understand that my health is the priority and will discontinue the program should a medical limitation happen. I understand that exercise can pose risks, and will be smart when it comes to training.
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Agree
Disagree
I hereby waive Mad Tuf Fitness from any responsibilities or liability of current or future injury/damage from partaking in an exercise program.
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Agree
Disagree
I have read, understand, and agree to all of the above information.
*
Agree
Disagree
Any other comments or questions you may have!
Submit
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