Wheat Ridge Parks & Recreation Forms

2. First Name*
3. Last Name*
4. Age*
6. Email Address*
7. Phone Number*
8. Zip Code*
10. Have you worked with one of our Personal Trainers before? If yes, please indicate who.
12. Do you prefer a male or female trainer?

    1. Male

    1. Female

    1. No Preference
14. Request a Trainer here:
16. What do you currently do for exercise? *
18. How often do you exercise? *

    Frequency (per week)

20. What other activities do you enjoy?
22. What improvements or deterioration have you noticed within the past 3 - 6 months in terms of your health and fitness?
24. Tell us a little bit about issues you want to address or things you want to improve upon:
26. What time of day would you like to train?*

    1. Early mornings before 8am
    2. Mornings 8am -12noon
    3. Afternoons 12-4pm
    4. Early evenings 4-7pm
    5. Late evening 7-9pm
28. Any questions?
Leave This Blank:


30. 1. Receive an email copy of this form.
31. Email address

    This field is not part of the form submission.

32. Submit

* indicates a required field