Personal Training Interest Form

Name*

First Name *

Name*

Last Name *

I am Currently a YMCA of Greater Birmingham Membership Member*

I am inquiring about:

One on One Training
Buddy Training
New Member Training Sessions
Birthday Special Sessions

The Y offers: 1 - One on One & Buddy Packages (4 | 8 | 12) in either 30 or 60 minutes offerings. 2 - New Member (1st 90 days of membership) intro Package (4 ) in 30 or 60 minute offerings 3 - Two Free 30-minute PT sessions during your birthday month!

Email Address*

Phone*

Date of Birth*

Zip Code*

Preferred Branch*

Preferred Method of Contact*

Trainer Preference*

Male
Female
No preference

Availability/Preference (Days)*

Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Availability/Preference (Time of Day)*

Early morning
Mid morning
Noon
Afternoon
Evening

Goals or Helpful Information