FREE Online Training Application Form

Basic Details

First name*

Last name*

Date of birth*

Day

Month

Year

Email*

Phone

Suburb*

e.g. Beachlands or Maraetai

Training Background & Goals

What made you want to apply for this?*

What are your top three goals over the next four weeks?*

Build Strength

Improve fitness

Increase mobility

Improve confidence

Reduce stress

Improve athleticism

Other

What is your current exercise routine (if any?)*

Not currently exercising

1-2 times per week

3-4 times per week

5 + times per week

Other

Do you have any past injuries or movement limitations I should know about.

Commitment & Fit

Are you available to train at least three x per week between the 1st December - 28th December*

Yes

Depends

Why is NOW the right time for you to commit to this?*

This program requires consistency. Are you willing to show up to our programmed sessions unless sick?*

Yes

In return for free training, are you comfortable giving a testimonial at the end?*

Yes

Are you comfortable with me sharing your tagged posts on @humn.move.co's instagram / Facebook page?*

Yes

Last thing

Is there anything else you'd like me to know?

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Email*

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