Congratulations on Taking Advantage of Our 7-Day Foundational Program!Thank You For Your Interest!Thank you for your interest in our programs. Take 5-10 minutes to fill out the readiness questionnaire below and we will contact you within 24 hours to schedule your first appointment. Step 1 of 250%Regular physical activity is fun and healthy, and getting involved in a fitness program is very safe for most people. Please fill out the PAR-Q and answer the questions below to determine whether you are physically fit to proceed with an ongoing fitness program and whether a doctor's approval is necessary. Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly:Name First Last Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAntigua and BarbudaArgentinaArmeniaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFaroe IslandsFijiFinlandFranceFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKosovoKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSaint MartinSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSudan, SouthSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Country Date of Birth* Age*Phone*Gender*Email* How did you hear about us? 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(please specify below)Other:Is there a gym in your building?*YESNOAre you looking for any outcall training?*YESNOMedical ConditionsDo you have any of the following?Heart ConditionDiabetesAsthma - UncontrolledShortness of BreathArthritis - Bursitis RheumatismHerniaRecent SurgerySacroiliac ProblemAnginaHigh Blood PressueKnee ProblemsBack ProblemsOther Orthopedic issuesOther (please specify below)OtherHas your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?YesNoDo you feel pain in your chest when you do physical activity?YesNoIn the past month, have you had chest pain when you were not doing physical activity?YesNoDo you lose your balance because of dizziness or do you ever lose consciousness?YesNoDo you have a bone or joint problem that could be made worse by a change in your physical activity?YesNoIs your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?YesNoIf you answered "Yes" to any of the questions above, you may be required to bring a doctor's note before proceeding.By electronically signing below, you are certifying that the above statements are true and correct. First Middle Last HistoryAre you currently enrolled in a fitness program?* Yes NoIf Yes, what your current weekly schedule?What have you done in the past to promote your health & fitness?*How do you feel at this time?Describe your experience in athleticsFitness GoalsWhat are your fitness goals?*(Ex: weight loss, muscle gain, improve athletic performance, general fitness, etc.)Why do you want to start a training program?*What areas of your body do you want to focus on and why?*How long have you been thinking about achieving these goals?*Why have you waited until now?*What's different this time?*When would you like to start seeing results and when are you expecting to meet your fitness goals?*What do you expect it will take for you to achieve your goals within your desired time frame?Personal Training ProfileHave you ever worked with a personal trainer or fitness coach?* Yes NoIf Yes, how was your experience and were you satisfied with your results?If NO, why not?How would you rate your eating habits & understanding of nutrition as it relates to your goals?*ExcellentGoodFairPoorWhy?Do you currently take any vitamins or supplements?*YesNoIf so, what do you take and why?What days & times are you available to work out?How do you feel after a great workout? 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