Personal Training Registration

Personal Training Registration - New Clients

General Information
*NOTE* New Personal Training Clients - Many of our personal trainers are out for the summer.. As of 06/07/2021 there is a possibility that you will be placed on a waiting list to be paired with a trainer. *

I understand
Name *

First Name Last Name
Email *
example@example.com
Phone Number *

Area Code Phone Number
R#/Membership# (Numbers only) *
Age *
Date of Birth *

Month Day Year
Date
Is there anything you would like us to know about your health/lifestyle/general?

Personal Training Registration - New Clients

Par-Q: Full document
Based on your responses to the questions on the previous page, we will need you to fill out the full PAR-Q form. This can be completed with, or before you meet with your trainer. If you chose to complete this before you meet with your trianer, you may scan it and email it in. Please send to Sydney Lundberg, Personal Training and Small Group Training Student Supervisor. Sydney.lundberg@ttu.edu

Please know, that based upon your responses to the remainder of the form, we may require further guidance or clearance from a medical professional.

Personal Training Registration - New Client

Package Selection, Terms and Conditions, and Waiver
Will you be purchasing virtual, or face to face personal training sessions? *

Face to face Virtual
Which type of assessment would you prefer?

In person (more in depth and accurate analysis) +$17 Virtual assessment (Movement assessments and goal setting only) - Included with purchase of at least 3 virtual sessions.
Type initials to show understanding: The expiration policy requires that sessions be used within the semester the are purchased (3-16 sessions) or within one year of purchase date (24-32 sessions) *
Type initials to show understanding: Refunds on personal training packages and sessions will not be issued at any time for any reason including but not limited to relocation, illness, and unused sessions. In case of major illness, providing a doctors note will warrant a refund. *
I, the undersigned, being aware of my own health and physical condition, and having knowledge that my participation in the Recreational Sport’s Personal Training Program may cause injury, am voluntarily choosing to participate in the program. There are always certain risks associated with any physical activity. I understand these risks and declare myself physically sound and capable to participate in program offered through Texas Tech University Recreational Sports Office. The Personal Training Program is a program designed to guide me, safely and effectively, through an appropriate individualized fitness/exercise regime based on my initial fitness assessment and goal assessment. Following the completion of a health history form and possibly a doctor’s note and an initial consultation, I will be given an individual exercise program that focuses on increasing fitness to prepare me for normal activities of daily living. I realize that I have the option to discontinue any activity upon my own discretion. I also realize that all information obtained about myself through this program will be kept in strict confidence within the Personal Training Program. In making this activity available for your participation, Texas Tech University Recreational Sports Office assumes no responsibility for injury. The responsibility is assumed entirely by the participant. Participants should have adequate personal insurance coverage. “Having such knowledge, I do hereby release Texas Tech University, the State of Texas, the Board of Regents, employees and student employees of all liability related to injuries or accidents to myself which may occur as a result of participation in the Personal Training Program. I hereby assume all risks connected there with and consent to participate in the Personal Training Program.” *

Clear
Should be Empty:

	Monday	Tuesday	Wednesday	Thursday	Friday	Saturday	Sunday
Early Morning (6am - 8 am)
Mid-Morning (8am-10am)
Late Morning (10am-12pm)
Early Afternoon (12:00pm-2:00pm)
Mid Afternoon(2:00pm-4:00pm)
Late Afternoon/Early Evening (4:00pm-7:00pm)
Beyond 7:00pm

Personal Training Registration - New Clients

Personal Training Registration - New Client

Personal Training Registration - New Clients

Personal Training Registration - New Client

Personal Training Registration - New Client