Registration for Grant Trotter Personal Training
Please take a moment to fill out the information below. Your information is confidential and is only seen by me. I use this information for safe and effective program design. PLEASE READ UBF LIABILITY WAIVER IN LINK ABOVE.
Name *
Your answer
Sex *
Birth Date *
Your answer
Email *
Your answer
Mobile Phone *
Your answer
What is the best way to contact you?
mainly for scheduling
Emergency Contact Person *
Name/relationship/phone number
Your answer
How did you hear about Grant Trotter personal training?
Your answer
What do you need help with? *
check all that apply
Required
Are you currently exercising? If so, how often and what type?
Your answer
Please type all other relative information or goals into the box below.
Your answer
Cancellation and Expiration Policy
All personal training sessions expire 1 year after the purchase date. If an appointment is cancelled within 12 hours of the session start time the session may be forfeited. *
Required
Liability Waiver
UBF LIABILITY WAIVER, Full Text online. *
Required
Electronic Signature *
Type your full legal name
Your answer
Physical Activity Readiness Questionnaire (PAR-Q)
Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor? *
Do you feel pain in your chest when you perform physical activity? *
In the past month, have you had chest pain when you were not performing any physical activity? *
Do you lose your balance because of dizziness or do you ever lose consciousness? *
Do you have a bone or joint problem that could be made worse by a change in your physical activity? *
Is your doctor currently prescribing any medication for your blood pressure or for a heart condition? *
Do you know of any other reason why you should not engage in physical activity? *
If you answered Yes to any of the previous 7 questions please explain.
Your answer
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