Personal Training Registration

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PESONAL TRAING REGISTRATION

Name *

First

Last

Age

Height

Weight (lbs) *

Email Address *

Telephone Number *

Allergies

Foods Dislikes

Medical History & Injuries *

WakeUp Time *

Bed Time *

Desired Body Part you will like to see progress *

Chest muscles
Back muscles
Should Muscles
Arm Muscles (Bicep/Trciep)
Abdominal muscles
Leg muscles (Quads/Hamstring)
Glute Muscles
Cardiovascular
Core muscles
Grip strength (forearms and hands)

Supplements or Vitamins *

List of vitamins and/or supplements you take daily/weekly

How many meals a day you have ? *

A Brief description on how you currently eat *

What time of the day would you like to attend gym for training ? *

Are you currently Exercising? Briefly state your exercise routine. *

Desired Gym for Training

What is your individual goal? *

Referencing the above, state how much weight you will like to gain or lose

Upload your Image (See Instructions below)

Click or drag files to this area to upload. You can upload up to 4 files.

Maintain some distance from the Camera. Capture a complete body photograph from the front, and rear and angles with your arms raised in each image. Ensure that you have good lighting. A blank background with no distractions is prefered however, if this is not possible minimize as much distraction behind you such as doors, paintings, etc.

Paragraph Text

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