Personal Training Form

Personal Training

Contact information and goal setting
  • Date Format: MM slash DD slash YYYY
  • Leave blank if you are not a Brock student
  • Please list the days and time range
  • If none, please type 'none'
  • If none, please type 'none'
  • If none, please type 'none'
  • These rates listed are for Brock students. Package renewals: Save 10% if you have purchased any package in the last 6 months.
  • Training cannot begin until the PAR-Q has been completed and reviewed by a personal trainer. Please complete the following form http://eparmedx.com/wp-content/uploads/2021/01/ParQ-Plus-Jan-2021-Fillable.pdf
  • This field is for validation purposes and should be left unchanged.