Personal Training Interest

Interested in Personal Training
Full Name*

First NameLast Name
E-mail*
Phone Number*

Area CodePhone Number
Zip Code
Member Status*

MemberNon-member
Have you done your Fitness Health Appraisal with us?*

YesNo
Trainer Preference*

MaleFemaleNo preference
Are you interested in any specialized personal training?

Aquatic Personal TrainingMuscle Activation Techniques (MAT)Running ProgramsSports Performance Training
What days work for you?*

MondaysTuesdaysWednesdaysThursdaysFridaysSaturdaysSundays
And times?*

Early mornings (before 8:00 am)Mornings (8:00 am - 12:00 pm)Afternoons (12:00 pm - 4:00 pm)Evenings (4:00 pm - 7:00 pm)Late evenings (after 7:00 pm)
Please indicate your personal health & fitness goals (check all that apply).*

Lose weightFeel better/more energyCardiovascular fitnessImprove flexibilityImprove balance/stabilityInjury rehabLower cholesterol and or blood pressureImprove muscle tone/strengthImprove athletic performancePre/post-natalReduce stressReduce back painLearn how to use specific equipmentCreate a program to use at homeGeneral fitness
Do you have any physical or medical concerns that need to be addressed or that your trainer should be aware of?

YesNoI'm not sure
Please explain
Additional comments, questions, or goals
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Interested in Personal Training