PERSONAL TRAINING REQUEST FORM

Name:


Address:

City:

State:

Phone:

Email:



Please complete the following information so we can place you with the trainer who will best meet your needs.

What is the best way to reach you:
 Phone
 E-Mail

I prefer the training sessions to be in the:
 Morning
 Afternoon
 Evening
 Weekends
 Anytime

Please list any health concerns you may have (optional):



Briefly describe your health and fitness goals:


Thank you for completing our inquiry form. The information will be given to a personal trainer who will contact you to schedule your first appointment. Return the completed form to Jon Gutmann, jgutmann@richmondheights.org. If you have questions, please contact Jon at (314)655-3651. Non-members are welcome to train at THE HEIGHTS but are required to pay the daily fee to access the facility.