Application for Online Training

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For online training, please fill out the following information and paste into the contact form. By filling out and sending this form, you acknowledge and agree to the terms and conditions.

  1. Primary Email:
  2. First Name:
  3. Last Name:
  4. Sex:
  5. Age:
  6. Current Weight:
  7. Height:
  8. Allergies (if any):
  9. Injuries (previous and/or existing):
  10. Occupation:
  11. Goal (fat loss, muscle building, both):
  12. Do you have any body parts you’re seeking to place more emphasis on?
  13. What is your current training experience (beginner, intermediate, or advanced)? If intermediate or advanced, how long have you been training?
  14. How many days are you able/willing to train per week?
  15. Do you currently track your food (macro) intake?
  16. Are there any exercises you’re unable to perform? If so, which, and why?
  17. Additional Comments:
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