Name and home address:
2. Your Goals
What are your fitness goals? (Be specific)
Neck: Chest (normal):
Chest (expanded): Upper arm (flexed):
Upper arm (straight):
Wrist (around the protruding bone):
Waist (around the belly button):
4. Fitness, Nutrition and Lifestyle Profile
What is your weekly schedule like? (Be specific, include
work, school, activities, family responsibilities, hobbies,
Give a description of your eating habits for a typical
day (Be specific, include what you eat, drink, amounts,
times, any supplements, etc.)
Where do you train and what equipment is available to you?
What is your current routine? (Be very specific, include
days a week, exercises, weight used, sets, reps, etc.)
Do you have any Bone, Joint, Ligament or Tendon Problems?
(If yes, be specific and include any exercises that cause
pain or irratation and any exercises that you can perform
that do not cause problems)
Do you have any medical conditions?
Are you taking any medications/drugs?
Any other information you feel may apply?
I want to achieve my goals and am ready to get started with your online personal training; please design a custom training and nutritional
plan based on my specific needs and lifestyle. I understand that you
will personally guide me every step of the way by answering any
questions I have and by updating my training/diet program when needed
based on the feedback I give you. I promise to follow your advice and
stick to the program for the full amount of time I signed up for and that if I'm
not 100% satisfied, I can ask for a full Refund.
I also understand that you strongly advise me to check with my doctor
before following this or any exercise or dietary program. I realize
that your programs are designed to give me the best results for my
efforts and that I must work hard in order to get results, and that
you are only advising me and will not be with me when I'm training
and that you can not be held responsible for any mishap or injury
that may occur.
I am over 18 years old and agree to the above conditions, or
I am the parent or gaurdian of this person and agree to the above conditions.
Please Sign me up for: