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2. Pine Community Center Personal Training Inquiry Form

   Please complete the following form. This form will be submitted and reviewed by our Fitness Coordinator who will then select a personal trainer that best suits you. A trainer will be in contact with you within 2-4 business days to schedule your personal training sessions.

   
   

   Payment is not due until first session with a trainer.

4. Name of Participant
5. Age of Participant
7. Email Address
8. Phone Number
10. Best Contact Method
12. What are your current fitness/wellness goals?*

    Select all that apply

    1. Create and Maintain Healthy Habits
    2. Decrease Body Fat/Lose Weight
    3. Increase Strength/Build Muscle
    4. Sports Performance (improve agility & athletic performance)
    5. Reduce Stress & Improve Health
13. What is keeping you from achieving your fitness/wellness goals?

    Select all that apply

    1. Lack of Motivation
    2. Time
    3. Lack of knowledge where/how to begin
    4. Lack of results
    5. Lack of equipment
    6. Cost of training/gym membership
    7. Hitting a plateau
15. What motivates you?

    Select all that apply

    1. Accountability
    2. Having Fun
    3. Feeling Better
    4. Seeing Results
    5. Praise/Rewards
17. What TIME of day works best for you?

    Select all that apply

    1. Mornings
    2. Afternoons
    3. Evenings
    4. Other
18. What DAYS of the week work best?

    Select all that apply

    1. Mondays
    2. Tuesdays
    3. Wednesdays
    4. Thursdays
    5. Fridays
    6. Saturdays
    7. Sundays
20. Please list any additional information that you would want your trainer to know
22. Thank You!

    We look forward to helping you reach your health & wellness goals. A trainer will be in contact with you in 2-4 business days. 

Leave This Blank:


24. 1. Receive an email copy of this form.
25. Email address

    This field is not part of the form submission.

26. Submit

* indicates a required field