Let’s Work Together

Name *

First Name

Last Name

Phone *

(###)

###

####

Date of Birth *

MM

DD

YYYY

Have you purchased a training plan? *

Yes

No

What are your short term goals for the next six months?

Fat Loss

Tone / Gain Muscle

Get Stronger

Improve Cardio Endurance

How much weight do you hope to lose or gain within the next six months? *

5-10

10-20

20+

How many days per week are you currently attending the gym? *

0

1-2 Days

2-5 Days

5+

How would you rate your gym experience/knowledge ? *

Beginner

Intermediate

Advanced

What do you do for work? From a scale of 1-5 is it physically active or sedentary? (1 - sedentary, 5 - physically active) *

1

2

3

4

5

How many meals do you prefer to eat ? *

3

4

5

Do you prefer to train in the morning/afternoon or evening? *

Morning

Afternoon

Evening

Liability Waiver

Before submitting the form, please read our Liability Waiver (this will open in a new window) By signing below, client acknowledges and warrants that he/she has read and understood this entire agreement (1 through 7) and that he/she agrees to be legally bound to the terms and conditions of this agreement.

I read the Liability Waiver

I consent