West Covina Personal Training Application

1

Full Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@example.com

3

Phone Number* This field is required.

Area Code

Phone Number

4

Age?* This field is required.

5

Occupation?* This field is required.

6

Zip Code* This field is required.

7

What fitness results do you want to achieve?* This field is required.(e.g., lose weight, build muscle, increase energy)

8

How committed are you (1–10) to changing your habits and improving your fitness?* This field is required.

1
2
3
4
5
6
7
8
9
10

9

How many sessions per week would you prefer to train with me?* This field is required.

10

What time of day do you prefer to work out?* This field is required.

Morning

Afternoon

Evening

11

How soon are you looking to start your training?* This field is required.

Immediately / Within 1 week

Within 1 month

In 1-3 months

Just exploring options

12

Do you have any current injuries or health concerns?* This field is required.

13

1-on-1 Private Sessions are $75 each. Are you ready to invest in a stronger, healthier, and more confident version of yourself?* This field is required.

Yes, I’m Ready to Transform!Out of my budget, but I’d be interested in semi-private training.