N.E.W. FITNESS
Personal Fitness Training for Women Only
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*Name
*Home Phone Number
Work Phone Number
*Email Address
*What Type Of Training Are You Interested In?
-Select a choice-
Group Personal Training
Partner Personal Training
One On One Personal Training
*How Often Do You Want To Meet With Your Trainer?
-Select a choice-
once a week
two times per week
three times per week
daily
*Your Objective
weight loss
body toning
general conditioning
strength training
nutritional counselling
carido training
flexibility training
stress management
bodybuilding
sports specific training
circuit training
injury rehabilitation
*Service Needed
workout supervision
fitness advice and supervision
program design
diet management and nutritional advice
existing program advice
injury recovery
*Current Schedule-How Often Do You Exercise ?
-Select a choice-
almost never
once a month
once a week
several times per week
daily
*Are You Recovering From Injury?
-Select a choice-
yes
no
*What Is Your Age Group?
-Select a choice-
21-25
26-35
36-45
46-55
*When Would You Like To Begin Training?
-Select a choice-
as soon as possible
within one week
flexible
Additional Information That Your Trainer Should know?
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