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Sign Up Form
(1 Month + 3 Sessions
)
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Name
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First
Last
Email
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Phone Number
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I am a Military, LE, or First Responder
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Yes
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Age
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State
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Height
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Weight
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How many times a week you train on average?
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Once per week
2 to 3 times per week
4 to 5 times per week
6 to 7 times per week
How many years have you been lifting?
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Less than 1 year
1 - 2 years
3 - 5 years
6 - 10 years
More than 10 years
How many hours do you sleep each night on average?
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What style of squat do you prefer?
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Low Bar
High Bar
Not Sure
What style of deadlift do you prefer?
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Conventional
Sumo
Not Sure
Do you have intentions of competing in a powerlifting meet within the next year?
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Yes
No
Maybe
How many times a week do you Squat?
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How many times a week do you Bench?
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How many times a week do you Deadlift?
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What are your current Squat, Bench, and Deadlift PRs?
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What type of specialty bar(s)/equipment do you have access to?
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What is your athletic background? Sports?
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Do you have any previous injuries that could affect training?
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Yes
No
If Yes, please indicate injury and severity below.
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What are your specific training goals?
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Are you interested in game day coaching for meets?
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Yes
No
Maybe
How did you hear about me?
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Instagram
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Other
If Other, please specify.
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Were you referred by a current client?
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Yes
No
If yes, who?
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***LIABILITY RELEASE STATEMENT***
I ACKNOWLEDGE THAT I AM CURRENTLY HEALTHY ENOUGH TO PARTICIPATE IN PHYSICAL ACTIVITY AND UNDERSTAND THAT THE COACH, COLLIN WHITNEY, OR WHITNEY STRENGTH & PERFORMANCE LLC WILL NOT BE LIABLE FOR ANY INJURY THAT MAY OCCUR DURING A TRAINING PROGRAM, PERSONAL TRAINING SESSION, OR UPCOMING MEET(S)/EVENT(S) DURING OR AFTER COMPLETION OF A SESSION OR PROGRAM.
Please indicate that you understand and agree to the Liability Statement by e-signing below.
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I agree to comply with the Liability Release Statement above.
Signature
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Date
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***PERSONAL TRAINING POLICY***
By signing this agreement, I understand and agree to the terms and conditions of the Personal Training Policy. This agreement is enforceable by law and the methods described below will be used in when applicable: The penalties could include additional fees.
This agreement is binding.
Failure to meet its terms will allow Whitney Strength & Performance LLC to take certain recourse. First, No-Show's will incur a fee of $45 and the session will be observed as completion of one session thus making the session nonfundable and ineligible for rescheduling. Second, Whitney Strength & Performance must be notified of session cancellation at least 12 hours prior to the scheduled session or the client will incur a $25 rescheduling/cancellation fee. Whitney Strength & Performance LLC understands that emergencies happen. In case of an emergency, please contact Whitney Strength & Performance LLC immediately so charges do not ensue. Thirdly, sessions will begin when scheduled. If the client is late, they will be allotted the remaining time of the session.
***BY SIGNING THIS AGREEMENT, I AGREE TO THE TERMS AND CONDITIONS AS DESCRIBED ABOVE***
Please indicate that you understand and agree to comply with the Personal Training Policy by e-signing below.
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I agree to comply with the Personal Training Policy indicated above.
Signature
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Date
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Submit
Home
About
PWRBLD Online
PWRBLD Account
Training
Level Up Program
Online Training Options
Personal Training
1:1 Consultation
Shop
PWRBLD Merch
Testimonials
Contact Me
Personal Training