Free Programme

Name:

*

Date of Birth:

*

Email:

*

Telephone:

Address:

*

Goals:

Please provide us with a brief outline of your goals.

Exercise History: (Please give details of most recent, If beginner please indicate.)

Do you consider your fitness levels to be..?
Poor Below Average Good Above Average Excellent

Are you known to have high blood pressure?
Yes No

Are you or were you recently pregnant?
Yes No

Any other details

Please give details of any medical conditions, medication, or other conditions (including joint and muscular pain).

Height cm

Weight kg

Will you be exercising at home or in the gym?
Home Gym

Do you have access to home gym equipment?
Yes No

How many times a week will you train?

Please give details of your requirements (IE - A diet plan, lower body workout for home use, full programme etc)

Thank you. We will email you a response as soon as possible.