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2. Name*
3. Date of Birth*
5. Phone Number*
6. Email Address*
8. Gender

   1. Male
   2. Female
10. What are your fitness goals (select all that apply).

    1. Lose Weight
    2. Gain Weight/Muscle
    3. Increase Strength
    4. Lose Inches
    5. Gain Inches
    6. Increase Flexibility/Mobility
    7. Improve Cardiovascular
    8. Health
12. Do you have a trainer you would like to work with?

    1. Christa Gibson
    2. Kevin Hinkle
    3. Zach Lewis
    4. Michelle Tucker
    5. Stephanie Furrow
    6. Brianna Jones
    7. no preference
14. Session Time Preference (select all that apply):

    1. Sunday afternoon
    2. Monday morning
    3. Monday afternoon
    4. Monday evening
    5. Tuesday morning
    6. Tuesday afternon
    7. Tuesday evening
    8. Wednesday morning
    9. Wednesday afternoon
    10. Wednesday evening
    11. Thursday morning
    12. Thursday afternoon
    13. Thursday evening
    14. Friday morning
    15. Friday afternoon
    16. Friday evening
    17. Saturday morning
    18. Saturday afternoon
16. Any additional information you would like to share.
18. List any additional particpants (Buddy / Group Sessions)
20. Name
21. Email Address
23. Name
24. Email Address
26. Name
27. Email Address
29. Terms and Conditions

    Personal training sessions are non-refundable.

    Personal trainers maintain the right to refuse service at their professional discretion.

    We require 24 hour notice for cancellations of your scheduled session. If you are unable to give 24 hours notice, you will be charged for the session.

    I acknowledge that I have disclosed all relevant health information accurately and understand that participation in physical exercise involves inherent risks. I agree to inform my trainer of any changes to my health status.

31. I acknowledge and agree to all of the terms and conditions stated above*

    1. Yes
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33. 1. Receive an email copy of this form.
34. Email address

    This field is not part of the form submission.

35. Submit

* indicates a required field