Personal Training Interest Form
(NOT swim lessons)
Today's Date
*
-
Month
-
Day
Year
Date
Name
*
First Name
Last Name
Age
*
Phone Number
*
-
Area Code
Phone Number
E-mail
*
jondoe@provider.com
Best way to Contact
*
Email
Phone Call
Text
Are you currently a member?
*
Yes
No
Personal Trainer Preference
*
Male
Female
No Preference
Specific Trainer
Select Trainer
*
Brad
Kent
Megan
Allie
Hannah
Michelle Bar
Michelle Cozine
Toni
Olivia
Ashton
Days Per Week You Would Like to Meet:
*
Once a Week
Twice a Week
Three times a Week
Other
What duration do you foresee yourself needing/wanting a trainer:
*
One Time
A Few Weeks
3-6 Months
Until I Reach My Fitness Goals
Just Looking for More Information
Best Time of Day to Schedule Personal Training Sessions
*
5:00AM to 10:00AM
10:00AM to 2:00PM
2:00PM to 6:00PM
6:00PM to 9:00PM
Prior experience with a Personal Trainer if any:
Briefly describe what you expect to accomplish through Personal Training:
*
Do you have any relevant medical conditions:
*
No
Yes
Medical Conditions:
*
Please verify that you are human
*
Submit Form
Should be Empty: