Berkeley Y Personal Training Interest Form
Fill out the form below and one of our trainers will be in touch shortly
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Are you currently a Berkeley YMCA member?
*
Yes
No
Tell us about your goals for Personal Training! Check all that apply.
*
Weight loss
Build muscle
Increase endurance
Increase flexibility
Increase balance
Training for specific event
One-on-one Pilates work
Pre or Postpartum training
Other
How often do you currently engage in physical activity?
*
Please Select
Minimal
Once per week
2-3 times per week
4-5 times per week
Daily
What days work best for you to train? Check all that apply.
*
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What part of the day works best for your training schedule? Check all that apply.
*
6:00am - 8:00am
8:00am - 10:00am
10:00am - 12:00pm
12:00pm - 2:00pm
2:00pm - 4:00pm
4:00pm - 6:00pm
6:00pm - 8:00pm
Submit
Should be Empty: