PERSONAL INFORMATION Name * First Name Last Name Email * Gender * Male Female Prefer not to say Date of Birth * MM DD YYYY Height in cm Weight in kg LIFESTYLE QUESTIONNAIRE What is your current occupation? How would you describe your current activity level? Sedetary Lightly Active Moderately Active Very Active Extra Active Do you currently exercise? Yes No Describe the activity that you do for exercise: Provide 3 exercises/activities which you prefer to have included in your programme: Provide 3 exercises/activities which you prefer not to be included in your programme: How many days per week you would like to train? * 1 - 3 4 - 5 6 - 7 Which days would you like to train on? * Monday Tuesday Wednesday Thursday Friday Saturday Sunday Where will you be training? * Gym Home Outdoors Travel If training at home, have you currently got any equipment available? Package * Base Camp Package: Personalised Training Programme Summit Package: Online Personal Training GOAL SETTING In order of urgency what are the top 3 reasons for requiring an online Personal Trainer? What are the 3 main barriers as to why you have not achieved your fitness goals? WEEKLY CHECK-IN PREFERENCE* *Subject to available time slots remaining. In case of your preferred day/time not being available an alternative slot will be discussed. On which day would you like to have your Check-in session with me? Monday Tuesday Wednesday Thursday Friday Saturday Sunday What time would be the most convenient? * 9 AM - 12 PM (Mon - Fri Only) 12 PM - 3 PM (Mon - Fri Only) 3 PM - 6 PM 6 PM - 8 PM How would you like to hear from me? * Email Recorded Video Feedback In-app Messenger WhatsApp Messenger WhatsApp Call Message I confirm that I have read the description of the packages offered, I understand the difference and I would like to sign up to the package selected above. * Thank you! I'll use information you provided to create your personalized training program. It will be ready within 48 hours.
