strength training interest form Name * First Name Last Name Email * Phone (###) ### #### May I text you at this number? * Yes No Date of Birth * MM DD YYYY Current Age * Tell me about your current activities. Please include exercise, physical hobbies, etc. * Are you experiencing any pain or injury? If yes, are you currently receiving assistance from a medical provider? * What are your goals? Please rate the importance of your goals (if you have more than one). How many times a week would you like to work out? Would you prefer to work privately or in a small group? Private Small Group What is your availability? Please check all that may work: Monday 9am Monday 10am Monday 11am Monday 1pm Monday 2pm Monday 3pm Monday 4pm Monday 5pm Wednesday 1pm Wednesday 2pm Wednesday 3pm Friday 9am Friday 10am Friday 11am Friday 1pm Friday 2pm Friday 3pm Thank you for your interest! I will be in touch within the next 24 hours!
