New Client Application
This form helps me get to know you before our initial consultation. By answering these questions you are not committing to making a purchase from Clint. By gathering information about your current fitness level, health history, preferences and objectives, we can begin to create a customized training program that aligns with your lifestyle and aspirations.
Name
First Name
Last Name
Email
example@example.com
Address
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
Please enter a valid phone number.
Date of Birth
-
Month
-
Day
Year
Date
Gender
Male
Female
What is your primary fitness goal? (You can choose more than one)
Lose Fat
Build Muscle
Improve Endurance
Tone/Shape
Bodybuilding/Competition Prep
Gain Strength
Other
What is your height?
What is your weight?
To make sure we are a good fit for 1-on-1 training I believe in the power of a video call or phone call. This can take anywhere from 15 to 30 minutes. Are you comfortable with this?
Yes
No
Do you understand that no magic pill, wrap, juice cleanse, or tea will get you where you need to be, and that hard work is ahead?
Yes
No
Clicking submit indicates that you are permitting Clint to contact you for 1-on-1 online personal training.
Submit
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