Liftingwithjamie - Coaching / Personal training Application
Please fill in the application form below, and I will get back to you with a personalised response as soon as possible!
Name
*
First Name
Last Name
Gender
Male
Female
Other
Date of Birth
*
-
Month
-
Day
Year
Date
Email
*
example@example.com
Contact Number
*
Please enter a valid phone number.
Format: (00000000000).
Current bodyweight
Please enter either kilograms (kg) or pounds (lbs).
Height
Please enter either centimetres (cm) or feet (ft).
What is your primary goal?
*
Fat Loss
Muscle Gain
Lifestyle Change
Strength/Performance Improvements
Other
Other than the above primary goal, what else are you looking to gain from the coaching process?
How often can you train?
1 x per week
2 x per week
3 x per week
4 x per week
5 x per week
Tell me at least ONE barrier that may stop you from achieving your goals?
Which gym(s) do you train out of?
*
Do you have any injuries? (current or previous)
When would be your ideal start date?
*
ASAP
Other
If selected 'Other' please tell me when.
Is there anything else you wish to ask or inform me on prior to us working together?
Submit
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