Online Training Form 1


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This new online program allows you to have the guidance of a personal trainer at an affordable price. This program is perfect for someone who is currently working out and just needs a little boost to their program and just some extra motivation to break through a plateau. With this service you will receive:

• A strength training program with pictures and descriptions that will be updated every month.

• A weekly cardio routine suited to your preferences.

• Nutritional guidance.

• Monthly fitness tips.

• Additional phone/email support to answer any questions that you may have.

Please fill out the following form.

Your Name:

Email Address:

Phone Number:

Address:

Sex:			Age:

Goals and Lifestyle Questions

How would you rate your current fitness level:

How many days per week are you performing cardio exercises:

How many days per week are you performing weight training:

How many days per week can you realistically devote to working out?

Please list any medical conditions, surgeries, or current injuries you may have:

Please list any medications you may be taking:

What type of exercise program would best fit your needs:

Which type of cardio exercise do you enjoy most:

Do you need nutritional help:

How many hours to you sleep a night on average:

Please list an average day of eating for you:

What type of exercise equipment do you have available to you? (Check all that apply)
Gym Equipment (home or club):

Dumbbells:

Resistance bands:

Stability ball:

Medicine ball:

None:

By initialing here you are confirming that you are 18 years of age or older and know of no reason why you should not participate in physically activity. You also realize that the program you receive is base on general recommendation and should not replace any program that has been prescribed by a doctor. You are voluntarily participating in the program and will stop immediately if any problems arise.