Online Coaching Registration Form
Form to register participants for online coaching sessions.
Full Name
*
First Name
Last Name
Date of Birth
*
-
Month
-
Day
Year
Date
Instagram Handle
Email Address
*
example@example.com
Phone Number
Please enter a valid phone number.
Format: (000) 000-0000.
Do you have any medical conditions, injuries, or limitations I should know about?
What is your fitness goal
Weight Loss
Building Muscle
Maintain Weight
Improve Confidence
Tell me a bit about your current training experience:(How long have you been training, what type of workouts you do, how many days per week you can realistically train, and whether you have access to a gym or train from home.)
Tell me about your current lifestyle and eating habits.(Include things like your general diet, if you track calories or macros, any food preferences or restrictions, your average sleep, stress levels, and whether you drink or smoke.)
What are your main fitness goals and why are they important to you?(Share what you want to achieve, what’s been holding you back, how you want to feel, and what success would look like in 3 months. If you’re working towards an event or specific date, mention it too!)
Tell me a bit about how you like to be coached.(Have you worked with a coach before? What did you like or dislike? How do you prefer to stay accountable — check-ins, messages, or app tracking? And finally, are you ready to commit to making real changes?)
Are you interested in adding in-person coaching sessions at Stadium Premier Fitness? (Additional cost applies – I will contact you to discuss)
Yes
No
Would you be interested in adding nutrition support or macros to your coaching? (Additional cost – I will contact you to discuss)
Yes
No
What is your current height, weight, and activity level?(Activity level examples: sedentary, lightly active, moderately active, very active)
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Please provide your signature to confirm your interest in this service
Submit
Submit
Should be Empty: