Personal Training Form

1

Name* This field is required.

First Name

Last Name

2

Email* This field is required.

example@gmail.com

3

Are you an existing Member of Sherborne Sports Centre?* This field is required.

YESNO

4

Phone Number* This field is required.

Please enter a valid phone number.

5

Date of Birth* This field is required.

Date

6

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?* This field is required.

YESNO

7

Do you feel pain in your chest when you do physical activity?* This field is required.

YESNO

8

Do you ever become dizzy when you do physical activity?* This field is required.

YESNO

9

Do you have a joint problem that could be made worse by exercise?* This field is required.

YESNO

10

Have you ever been told by a medical professional that you have high blood pressure?* This field is required.

YESNO

11

Are you currently taking any medication, which the instructors should be made aware of?* This field is required.

YESNO

12

Are you Pregnant or have you had a baby in the last 6 months?* This field is required.

YESNO

13

Do you have any known allergies?* This field is required.

YESNO

14

If yes to any of the previous questions please write a breif description here.

15

Experience in the gymhow much expeirence would you say you have in the gym

Beginner

Intermediate

Advanced

Not Sure

17

Goals or Focus AreaDo you have any goals your set on? Areas you want to improve?