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Personal Training Request Form

1. Client Information

Preferred contact
 

A. Fitness Goals

What are you trying to achieve? Check all that apply.
 

B. Fitness Information

On a scale of 1-10 (10 being highest), how would you rate your current fitness level?
 

C. Fitness Experience

What is your fitness activity experience?
 

2. Availability

Please specify which days and times you would be available.

Trainer Preference:
 

3. Location

Any personal information collected on this form will be managed in accordance with the Freedom of Information and Protection of Privacy Act. Direct enquiries, questions, or concerns regarding the collection, use, disclosure, or safeguarding of personal information associated with this form to: Supervisor, Information, Privacy, and Records Management, Township of Langley, 20338 – 65 Avenue, Langley, BC V2Y 3J1 foi@tol.ca 604.532.7396