CAIFITT COACHING JOTFORM

1

What is your full name?* This field is required.

First Name

Last Name

2

What is your email address?* This field is required.

example@example.com

3

What is your phone number?* This field is required.

Area Code

Phone Number

4

What is your DOB?* This field is required.

Date

5

What is your Instagram Handle?ex. @cairoptt

6

What is your gender?* This field is required.

Male

Female

Other

7

Which service(s) are you interested in?* This field is required.Personal Training & Online Coaching services will be tailored to your own personal goals (ex. physique, bodybuilding, weight loss / gain, hypertrophy, increasing overall strength, hybrid fitness etc). Programme Design is a separate service, in which you will have a programme created and updated for you every 4-6 weeks.

Personal Training (incl. In-person &/ or Online)

Programme Design

Online Coaching

Hybrid Fitness (incl. Running / Strength & Conditioning)

Other

8

What is your weight (KG)?* This field is required.Please input your last known weight if you do not know your current.

9

Are you dealing with any current or previous injuries?* This field is required.If yes, please provide further detail.

10

What are your training goals?* This field is required.Include your current training frequency (if applicable)

11

Ideal start date?* This field is required.When would you like your training programme to commence?

Date

12

Are you financially ready to invest in bettering your health? * This field is required.Personal Training & Coaching is an investment and a big financial commitment for some.

YESNO

13

Is there anything else you think I should know? This includes heart disease, high blood pressure or any other cardiovascular problem, chest pains associated with minimal effort, dizziness, bone / joint problems, pregnancy, diabetes, epilepsy etc.* This field is required.Moderate or vigorous exercise should not be a hazard for most people providing it is undertaken as part of a regular programme starting from low intensity and progressing gradually. However, some people will need medical evaluation and advice before starting a programme. Some may need to exercise under medical supervision and some people may only be able to undertake restricted physical activity under medical supervision. If you have answered 'yes' to any of the above questions, please describe in more detail as to why:

14

Signature* This field is required.

Powered by Jotform SignClear