Personal Training Intake Form

Full Name*

First NameLast Name

Phone Number*

Please enter a valid phone number.

Email*

example@example.com

Gender*

MaleFemale

Date of Birth*

MonthDayYear

Height*

Current Weight*

LBS

Are you a member of the Anthem Community Center?*

YesNo

How did you hear about my services?*

Community CenterReferred by friendSocial MediaGoogle

What is your occupation?

What's the activity level at your job?

none(seated only)Moderate (light activity such as walking)High (heavy labor, very active)

Do you have any diagnosed health conditions or medical issues that may affect your ability to participate in person training?*

YesNo

Which of the following best fits in with your goals?*

Please rate your motivational level to do what it takes for reach your goal. One being not motivated at all and ten being extremely motivated.*

Are you currently exercising regularly (at least 3x per week)?*

YesNo

Have you trained with a personal trainer before?*

YesNo

Sessions are offered Monday through Friday between the hours of 10:30am and 3pm.*

Yes, these days and times will work for meNo, these days and times don't work for me

Which package are you interested in?*

6 Sessions - 60 minutes12 Sessions - 60 Minutes24 Sessions - 60 MinutesAs many sessions needed to reach my goals

1.) HOURS

Sessions are offered Monday - Friday between the hours of 10:30am and 3pm.

2.) PACKAGE OPTIONS

6 Sessions $450

12 Sessions $840

24 Sessions $1,560

All sessions are 60 minutes in length and conducted at the Anthem Community Center. You must be an active member of the Anthem Community Center in order to use the facility and recieve training services. Package must be paid in full before reserving session dates. Session availability is first come first serve. It is recommended to book your sessions in advance. Sessions are booked directly with your trainer.

Two sessions per week for at least 6-8 weeks of constant training is recommended for maximum results and program adherance. These recommendations may change due to individual goals.

All packages are final sale and no refunds will be given for unused sessions. Sessions may not be transferred to another individual.

3.) SESSION EXPIRATION

To help clients stay consistent and get the best results, personal training sessions are subject to expiration. This ensures a commitment to regular training, which is essential for reaching fitness goals.

6 session packages expire 60 days after purchase

12 session packages expire 90 days after purchase

24 session packages expire 120 days after purchase

4.) MEDICAL ISSUES POLICY

Your health and well-being are the top priority. If a medical issue arises that affects your ability to continue training, please inform your trainer as soon as possible.

Temporary Medical Holds: If a medical condition (such as an injury or illness) temporarily prevents you from training, sessions can be put on hold for a maximum of 30 days. A medical hold requires documentation from your healthcare provider.

5.) CANCELLATIONS

Cancellations must be made at least 24 hours in advance of a scheduled session. Sessions cancelled less than 24 hours in advance will result in forfeiture of the session and a loss of the financial investment at the rate of one session.

6.) LATE ARRIVALS

Each session shall be 1 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. If client is more than 15 minutes late past their scheduled start time and has not communicated with trainer, the session will be marked as a no show/no call and will result in the loss of the session.

7.) ALL THE INFORMATION I HAVE GIVEN IS CORRECT

All the information on this form is correct and to the best of my knowledge. I understand that all the information given will be kept confidential.

I HAVE READ AND AGREE TO THE ABOVE TERMS & CONDITIONS*

YesNo

Personal Training Intake Form

Services & Policies