TWENTY2SIX

TWENTY2SIX
PARTICIPANT INFORMATION
How did you hear about us?*
Name*
DOB*
Address
Age
City
State
Zip Code
SETTING YOUR HEALTH AND FITNESS GOALS
How can a Professional Trainer help you? Please select all that apply.*

Lose Body FatDevelop MuscleRehabilitate an InjurySafetySport Specific TrainingMotivationAccountabilityNutrition EducationCrossFitPowerlifting
Other
1. Please list in order of priority, the fitness goals you would like to achieve in the next 3-12 months?
A.*
B.*
C.*
2. How will you feel once you've achieved these goals? Be specific.*
3. Where do you rate your health in your life?*

High PriorityMedium PriorityLow Priority
4. How committed are you to achieving your fitness goals*

VerySemiNot Very
5. What do you think the most important thing your Professional Trainer can do to help you achieve your fitness goals?
6. Outline what you feel are obstacles or your potential actions behaviors or activities that could impede your progress towards accomplishing your goals.. ie not training consistently, upcoming vacation busy, season at work, not following the program, allowing other responsibilities to become a priority over your training etc..
7. Outline 3 methods you plan to use to overcome these obstacles:
a
b
C
Congratulations on your decision to improve your health and achieving your fitness goals by participating in a professional fitness program! With the help of your professional trainer, you greatly improve your ability to accomplish your training goals faster, safer, and with maximum benefits.

In order to maximize progress, it will be necessary for you to follow program guidelines. Remember, training and healthy eating are EQUALLY important!

It is recommended that all program participants train at least three (3) to four (4) times per week. Depending on your goals video submission may be required.
TRAINING SCHEDULE:
How many days a week do you plan on training
What form of training are you currently doing
What is your current training schedule:
M
T
W
TH
F
S
S
Will you train at home?
Will you train at a gym?
If so, which gym?
EQUIPMENT: If you will be training at home please list your equipment
1
2
3
4
5
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12
Notes
Should be Empty:

TWENTY2SIX

PARTICIPANT INFORMATION

SETTING YOUR HEALTH AND FITNESS GOALS

TRAINING SCHEDULE: