Register for Kinesiologist

Parents Name (If applicable)

First Name

Last Name

Phone Number

Email

Emergency Contact Name

Emergency Contact Phone Number

Height (Inches)

Weight (Pounds)

Date of Birth (Month, Day, Year)

Current Occupation

List any medical conditions we should know about

Is there any exercises you cannot perform or cause you pain?

Are you currently involved in any sport? If so, what sport, and what level?

How would you rate your current level of fitness

Very Poor: I rarely exercise and have difficulty with physical activities. Poor: I exercise occasionally but struggle with consistency and endurance. Fair: I exercise regularly but still have room for improvement in strength and stamina. Good: I maintain a consistent exercise routine and feel generally fit. Very Good: I exercise frequently and have good strength, endurance, and flexibility. Excellent: I am highly active, participate in intense workouts, and feel at peak fitness.

What is your training experience, if any?

No Experience: I have never engaged in any formal training. Beginner: I have some experience but am still new to structured training. Intermediate: I have been training regularly for a while and have a good understanding of basic exercises. Advanced: I have extensive training experience and am familiar with advanced techniques and exercises. Expert: I have a high level of training experience, possibly including coaching or competitive experience.

Current cardio program, if any (minutes per day, type, and consistency)?

No current cardio program Less than 30 minutes per day More than 60 minutes per day Walking (occasionally, regularly, daily) Running (occasionally, regularly, daily) Cycling (occasionally, regularly, daily) Swimming (occasionally, regularly, daily)

What time of day do you hope to book your personal training sessions

Early Morning (5 AM - 8 AM): Start your day with an energizing workout. Mid-Morning (8 AM - 11 AM): Perfect for those who prefer a mid-morning boost. Lunchtime (11 AM - 2 PM): Fit in a workout during your lunch break. Afternoon (2 PM - 5 PM): Ideal for an afternoon pick-me-up. Evening (5 PM - 8 PM): Great for winding down after a busy day. Late Evening (8 PM - 11 PM): Perfect for night owls who like to train late.

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Let's learn more about your goals

When are you looking to start training?

What do you hope to achieve by working with us as your personal trainer?

What is your commitment level to achieving your fitness goals?

Not Committed: I’m just exploring my options and not ready to commit yet. Slightly Committed: I’m interested but have other priorities that might take precedence. Moderately Committed: I’m willing to put in some effort but might struggle with consistency. Committed: I’m ready to make a regular effort and prioritize my fitness goals. Very Committed: I’m highly motivated and ready to make significant changes to achieve my goals. Fully Committed: I’m all in and ready to do whatever it takes to reach my fitness goals.

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Help us Improve

How did you find out about us?

Web Search: I found you through an online search. Referral: Someone recommended you to me. Existing Iron Lore Member: I heard about you from a current Iron Lore member. Instagram: I discovered you on Instagram. Facebook: I found you on Facebook. Other: Please specify.

How did you find us (other)

Please tell us any additional information you would like us to know about yourself

Riley Carson, Kinesiologist, (CSEP-CPT)