YMCA of Greater Charlotte PT Inquiry Form
Share your preferences with us
Select Center *
Brace Family
Childress Klein
Dowd
Harris
Harris Express
Johnston
Keith Family
Lake Norman
Lowe's
McCrorey
Morrison
Sara's
Simmons
Stratford Richardson
First Name *
Last Name *
Date of Birth *
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Email *
Phone Number *
Preferred Method of Contact *
Email
Phone
I found out about the Personal Training Program through *
Website Search
Friend/Referral
Other
I found out about the Personal Training Program through - Other
Is there a personal trainer that you would prefer?
What days are the most convenient for you? *
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday
What time of day is the most convenient for you? *
Early morning
Mid-morning
Afternoon
Evening
The most important goal for me is: *
Weight loss, decrease body fat, increase muscle
Athletic endurance and/or strength
Accountability
Rehab injury/strengthen after injury
Overall health
Sport specific training
Other
Goals - Other
How often do you wish to train? *
1x /week
2x /week
3x /week
> 3x /week
What kind of individual sessions package are you interested in pursuing? *
The 30 minute option is not available for Dowd YMCA or Childress Klein YMCA.
30 minutes
45 minutes
60 minutes
What date would you like to get started? *
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DD
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28
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30
31
YYYY
1900
1901
1902
1903
1904
1905
1906
1907
1908
1909
1910
1911
1912
1913
1914
1915
1916
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1941
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1951
1952
1953
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1961
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1971
1972
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1976
1977
1978
1979
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1981
1982
1983
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1989
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1991
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Do you have any health conditions or important information we need to better serve your needs and find you the right program? *
Yes
No
Please explain
Submit