Fitness Assessment Template & Personal Training Registration Packet printable pdf download

Fitness Assessment Template & Personal Training Registration Packet

Fitness Assessment & Personal Training Registration Packet

Thank you for your interest in the Springfield College Personal Training program. It is our goal to assist you in

reaching your personal fitness goals. These sessions will focus on developing your fitness program according to

your fitness level, goals, time commitments and interests. If you have any questions regarding the questionnaire

or the personal training program, you can reach the Fitness & Wellness Graduate Associate at x3723.

I. Participant Information

Last Name:

First Name:

Gender:  Male  Female

Date of Birth:

Primary Phone #:

Secondary Phone #:

Street Address:

Town:

State:

Zip Code:

Emergency Contact:

Emergency Phone #(‘s):

Select the appropriate category that describes you:

 Full-Time Undergraduate Student

 Full-Time Graduate Student

 Part-Time Undergraduate Student

 Part-Time Graduate Student

 Employee

 Other: __________________________________

Please select one:

(

Please note that students and employee wellness participants receive one free assessment per academic year. Employee

wellness participants also receive two complimentary personal training sessions.)

 I am registering for a Fitness Assessment only.

 I am registering for Personal Training sessions.

 # of sessions registering for: _______

 Have you completed a Fitness Assessment?  Yes  No

 If yes, when? ________________________

 Trainer Preference (if applicable):_______________________________________________

 Are you registering with a partner or group?  Yes  No

 If yes, please list their names:

_______________________________________

Fitness Assessment Template & Personal Training Registration Packet