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 Personal Training Registration

All information submitted through this form is confidential and visible to your trainer only.
Should you have any questions regarding this form, please let us know and we will be happy to assist!

Name *

Email *

Phone *

Physical Activity Experience

Resistance-Training Experience

Current Weight *

Height *

Date of Birth *

Current Weekly Activity Level * For example, if you work an office job with no weekly exercise, that would be considered sedentary. Select Sedentary Moderately Active Very Active

What are your goals?

How many days per week (minimum) are you able to exercise? * Select 1 day per week 2 days per week 3 days per week 4 days per week 5 days per week 6 days per week

Program Type In Person Training Online Coaching Not sure yet

Ideally, when would you like to start your program?

Preferred Check-in Communication *

Email Text / SMS What's App

Pre-Existing Injuries / Health Conditions

Dietary Restrictions / Allergies (if any)

Supplements & Medication

Please upload a picture for your fitness profile The maximum file size is 15mb (jpg, jpeg, png, pdf, doc, heic)

Additional Notes

I have read, understood & accept the Terms & Conditions.

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