Interested in Youth Personal Training
Parent's Full Name
*
First Name
Last Name
Parent's E-mail
*
Parent's Phone Number
*
-
Area Code
Phone Number
Child's Full Name
*
First Name
Last Name
Child's Age
Trainer Preference
*
Male
Female
No preference
What days work best to train?
*
Mondays
Tuesdays
Wednesdays
Thursdays
Fridays
Saturdays
Sundays
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 weight
Feel better/more energy
Cardiovascular fitness
Improve flexibility
Improve balance/stability
Injury rehab
Improve muscle tone/strength
Improve athletic performance
Reduce stress
Learn how to use specific equipment
Create a program to use at home
General fitness
Does he or she have any physical or medical concerns that need to be addressed or that the trainer should be aware of?
Yes
No
I'm not sure
Please explain
Additional comments, questions, or goals
Submit
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