Personal Trainer Request Form
Please complete the information below to have one of our trainers contact you about creating a personalized fitness program.
Your email adress:
Your Name:
Phone Number:
Please have the following trainer contact me: Any Trainer Adam Barron Lou Ann Bennett Danita Chandler David Clapp Mick Glaze Lora Lee Lila Ojeda Suzie Trefzger
I am a current member of Trainer's Club I am not currently a member of Trainer's Club
I am interested in the following type of training: General conditioning P.E.P. training program Speed, agility, and quickness Breast cancer survivor fitness General fitness & good health Senior fitness Pre-natal/post-natal Golf Tennis Pilates Football Body shaping and building Decrease body fat Increase muscle tone Improve diet & eating habbits
I would like to work with a trainer 1 2 3 4 5 6 7 times each week
I have worked with a personal trainer before I have not worked with a personal trainer before
I have the following injuries or special considerations:
