Personal Training Registration Form

Client Details

First Name

Last Name

Date of Birth

Preferred Contac tNumber

Emergency Contact Name

Emergency Contact Number

Availability

Our personal trainers are available to meet with clients during our normal operating hours. Each semester we have trainers available

Monday - Thursday: 6:30 a.m. - 11 p.m.
Friday: 6:30 a.m. - 10 p.m.
Saturday & Sunday: Noon - 10 p.m.

During spring, summer and winter breaks we have trainers available

Monday - Friday: 6:30 a.m. - 9 p.m.
Saturday & Sunday 10 a.m. - 4 p.m.

Ideally how often would you like to meet with your trainer?

Once a week

2x week

3x week

Bi-weekly

More on a monthly basis

Other

Please list your current availability to meet with one of our trainers (list as many days/times that work for you)

Do you have a preference for your training location?

No Preference

Campus Recreation Center - East Campus

Riverview Fitness Center - South Campus

Activity Questionnaire

Please give a brief description of your current workout routine or previous routine, if any

If you stopped following your workout routine, why did you stop?

Do you have any favorite recreational activities/hobbies and if so what are they

What is your occupation and does it involve long periods of sitting and/or inactivity?

Goal Setting

What are your primary fitness goals? Please select the appropriate option(s) below

Weight loss

Improve overall fitness

Strength/muscle gain

Train for event/competition

Improve fitness knowledge and/or technique

Other

Can you foresee any barriers that might interfere with you reaching your goals? If yes, please describe

Affiliation With University

UMass Lowell Student

UMass Lowell Faculty/Staff

CRC Paid Full Member

CRC Paid Master's Member

Please Note: We cannot setup your initial session with your personal until this form is completed. Depending on your answers we may be required to gain medical clearance before you can meet with your personal trainer. If medical clearance is necessary, we will work with your physician to gain this clearance and typically takes 2-3 business days.
Health History Questionnaire Form

* required fields

Personal Training Registration Form

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