FITNESS PROGRAM

On becoming a member of Momentum Fitness Warrnambool you are elegible for a Free complimentary Fitness program on sign up.

Please fill in the form as accurate as you can so that our Instructors can make your program to suit you, including what you would like to achieve from your training.

If you would like to be taken through your program it is $45.00. This is perfect for those who are unsure of all of the equipment and never been to a gym before, or for those who havent trained in a while. It will also give you an opportunity to talk to the trainer more about your needs and want you would like in your program.

Date*

Date

Name*

First NameLast Name

Age*

Phone Number*

Your program will be emailed to you after your initial session with the trainer.

Email*

example@example.com

Height

Weight

Have you been to a gym before?*

YesNo

Are you currently training?*

YesNo

If Yes, how long have you been training for?

How many days do you train?*

Are these consecutive days?

YesNo

What are your goals?*

How long do you want each training session to be? For eg. 1hr, 1/2hour*

If other, please explain:

Do you have a sporting back ground?*

YesNoYes - but a very long time ago

If yes what sport do you play?

Or use to play

Do you have any injuries past or present?*

YesNo

If yes what is your injury?

If past is this still an issue?

If you would like to be taken through your program, please contact us on 0427 456 563, Or book an appointment at the desk.