Please enable JavaScript in your browser to complete this form.Name *FirstLastEmail *Are you a current YMCA at ACRC member? *YesNoAgeWhy are you interested in Personal Training? *How long have you consistently exercised?No Consistent Exercise1-2 Years3-5 Years5+ YearsIf you consistently exercise, how many days per week?1-2 days/week3-4 days/week5+ days/weekHow many hours of uninterrupted hours of sleep do you get each night?Under 5 hours5-6 hours7-8 hours8+ hoursWhat time do you typically go to sleep each night? *What time do you typically wake each morning? *Are you currently or have you ever followed a nutrition program?YesNoIf so, what worked, what did not and why?Please write out what you ate yesterday from waking, until bedtime.Are you interested in purchasing sessions for Personal Training? *YesNoSubmit