Personal Training Inquiry Form

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Personal Training
Orientations
Fitness Consultation/Assessment

Personal Training Inquiry Form

Please fill out the form below and a member of our team will be in touch soon!

First Name (required)

Last Name (required)

Phone Number (required)

Age

Email (required)

Preferred Method of Communication (required)

Phone

Are you interested in a Personal Training Package? (required)

Basic Training Package. Includes (2) 60 minute sessions (12) personal workouts, weekly check-ins from a Personal Trainer. $200/4wks

Basic Training & Nutrition Package. (1) 60 minute Basic Nutrition Session and everything from the Personal Training Package. $275/4wks

If not, please select this option.

Will this be a group training session? (required)

Yes

If yes, who are the other group members?

Do you prefer a male or female trainer? (required)

Male

Female

No preference

Is there a specific trainer you would like to work with?

Have you worked with a personal trainer before? (required)

Yes

Do you currently perform any type of physical activity?

Yes

If yes, how often?

1 time / week

2-3 times / week

4-5 times/ week

Daily

What does your physical activity consist of?

How many times per week would you like to train? (required)

Would you like 30 or 60 minute sessions? (required)

30 minutes

45 minutes

60 minutes

What part of the day would you like to train? (required)

5:00-8:00 am

9:00-12:00 pm

1:00-4:00 pm

5:00-close

weekends

What are your health and fitness goals?

weight loss

increase flexibility

enhance athletic performance

increase cardiovascular endurance

increase energy

stress management

increase strength

improve posture

other

Please indicate other specific goals you have in regards to your exercise program:

Additional Comments

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822 18th Street East, Williston ND 58802

Telephone (701) 572-9272

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