Personal Training Application Form
  • Please select your preferred form of contact*
  • Gender*
  • What is your current fitness level?*
  • How often do you exercise per week?*
  • What types of physical activity do you enjoy?

  • Are you experiencing any stresses or motivational problems?
  • Do you suffer from diabetes, asthma, high or low blood pressure?
  • Are you a current cigarette smoker?
  • Your current diet could be best characterized as:
  • Please rate your readiness for change.
  • What following goals does best fit in with your goals?
  • Rows
  • Are you currently excersising regulary (at least 3x per week)?
  • Have you trained with a personal trainer before?
  • At what times during the day would you prefer to train?*
  • PAYMENT PLAN*

  • Please Read The Following Terms and Conditions.

  • 1.) CANCELLATIONS

    Cancellations should be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will be charged in full to the client.

    2.) LATE ARRIVALS

    Each session shall be 1.5 hour in length. Sessions will not be extended (unless time is available) due to the lateness of the client or due to interruptions caused by the client.

    3.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

    All the information on this form is correct and to the best of my knowledge. I have sought and followed any necessary medical advice. I understand that all the information given will be kept confidential.

  • I consent to videos/pictures being taken during sessions*
  • I AGREE TO THE ABOVE TERMS & CONDITIONS!*
  • Should be Empty: