Personal Training & Online Coaching Application
* fill out this form to apply for personal training services. submitting an application does not guarantee your selection.
Full Name
*
First Name
Last Name
Email Address
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Age
*
6yo+
Height
*
Gender assigned at birth
*
Please Select
Male
Female
Current Weight
*
Goal Weight
*
What type of coaching are you looking for?
*
Please Select
In Person
Online
Hybrid (In person & Online)
FREE 15wk portfolio
Only accepting WOMEN, COUPLES, YOUTH ATHLETES for IN PERSON! Online coaching is open enrollment to all.
If you chose In Person or Hybrid Coaching, Where are you currently located?
*
*My services are mobile, meaning i do not work out of a facility but rather travel to you and train you from your home/public park with either your own equipment or my own equipment!
Have you worked with a personal trainer before ? If yes, what was the reason you stopped ?
*
How committed are you to this fitness journey ?
*
i’ve changed many of my clients lives and would love to be apart of your journey, once you start there’s no turning back!
What are your primary fitness goals?
*
How would you describe your current activity level?
*
Please Select
Beginner
Intermediate
Advanced
What is currently stopping you from being more active?
*
Do you have any medical conditions, injuries, medical surgeries , or cosmetic surgeries I should be aware of?
*
How likely are you to follow a meal plan?
*
Please Select
Somewhat Likely (1-5)
Very Likely (6-10)
Somewhat unlikely (1-5)
Highly unlikely (6-10)
Describe your eating habits.
*
(Binge eating, trouble eating, sweet tooth, etc)
Do you have any food allergies or lactose intolerances?
*
What is your water intake level?
*
Please Select
less than half gallon daily
half gallon or more daily
On average how many hours of sleep are you getting?
*
Please Select
7 or more
6 or less
How demanding is your career/work environment?
*
How many days a week are you looking to train ?
Please Select
1
2
3
4
5
Preferred days/times for training sessions
*
Availability varies weekly, schedule is first come first serve. (M-F 8am-8pm) (Saturday's 9am-1pm) (Sundays CLOSED)
How soon are you looking to start based on your availability?
*
-
Month
-
Day
Year
Date
Hour Minutes
AM
PM
AM/PM Option
Are you willing to submit weekly check in photos ? ( face may be blurred)
*
Yes
No
File Upload
Browse Files
Drag and drop files here
Choose a file
*Applicants must submit initial check in photo to be reviewed by coaching staff
Cancel
of
Signature
*
Submit Application
Submit Application
Should be Empty: