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Medical and Training Questionnaire

Please fill out the following form to help us understand your physical condition.

First Name

Email Address

Last Name

Date of Birth

Have you been hospitalized in the last 12 months? *

No

Yes

Are you currently suffering from a medical condition, illness, or injury? *

No

Yes

If you answered yes to any question, please elaborate

Are you currently exercising?

Yes

No

If yes, how many days a week and for how long?

What are your goals, or what would you like to achieve through our training?

How many days a week are you looking to train together?

Would you be interested in faith components of training (Bible studies, devotionals, etc.)?

Yes

No

I declare that the info I’ve provided is accurate & complete

Initials

Today's Date

Thanks for submitting!

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