Information Form
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Email *
Phone number:   *
Name: *
Age: *
Which service are you most interested in? *
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DOB
Weight: *
Height: *
On a scale of 1 - 10, how would you rate your overall fitness? *
mashed potato on a couch
Batman idolizes Me
What are your goals? (check all that apply) *
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Is this a new goal? (an active pursuit of 6 months or less) *
What worked well for you in the past that helped you get closer to your goals?
Have you worked with a Trainer Before? *
NUTRITION:
Please tell me a bit about what you're currently eating and drinking...
Are you currently doing anything specific with your diet or nutrition? If so what type of program are you following?
MINDSET
How long do you imagine it will take to achieve your fitness goal? *
On a scale from 1 - 10, how committed are you to getting results? *
I'm not
Armageddon wouldn't stop me!
What conflicts are currently preventing you from achieving your goals?
By undertaking training I understand that inherent injury risks are involved when performing physical activities even when performed under the guidance of a professional instructor.  I take full responsibility for my personal safety and any injuries I may incur. *
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