Required fields are marked with asterisks (*)

Personal Trainer Request Form

Your personal information is being collected under the authority of section 25 of the Local Authority Freedom of Information and Protection of Privacy Act. This information will only be used to administer the program/activity it was collected for. If you have any questions about the collection please contact the Office of the City Clerk at 780-875-6184 or email cityclerk@lloydminster.ca

First Name:

Last Name:

Email Address

Phone Number

What time of day works for your schedule? (Choose all that apply)

a. Early mornings (before 8 am)

b. Day time (8 am - 5 pm)

c. Evenings (5 pm or later)

d. Weekends

Comments:

How often do you plan on meeting with your trainer?

a. More than 3 x per week

b. 2 x per week

c. 1 x per week

d. Every couple weeks

e. Often at first and then reassess every month or two to refresh

Comments:

Approximately how many sessions are you looking for?

a. 1-3

b. 3-10

c. 10+

d. 1 FREE Fitness Orientation

Comments:

Is there anything specific you are looking to get out of the training? (Choose all that apply)

a. General Health

b. Sport-Specific Training

c. Assistance with something specific

d. Injury rehab/maintenance

Comments:

Is there anything else you want us to know before we match you with a trainer?

Forms

Personal Trainer Request Form