Fitness Online Registration
Personal Training

Fields marked with an * are required.

Personal Information
Full Name*:
Local Phone: (i.e. 232-8467, no area code)
E-mail*: (i.e. jbob@vt.edu)
Status:
Gender:
How did you learn about the Personal Training Program?
If you learned about the Personal Training Program from a Trainer, please select his or her name so he or she can be entered into a drawing for a prize. The Trainers will appreciate your entry. Staff Roster

Program selected
Session Package*: [See Packages]
Semester*:
How many days a week do you plan to work with a trainer?*:
What time of the day would you prefer to workout?*:
Select a personal trainer*: [See Trainer Bios]
Description of fitness goals?

Policies and Agreement

Carefully note the following policies:

  • All sessions must be used during the semester in which they were purchased or they will be forfeited.
  • Refunds are ONLY given for medical reasons, and medical documentation is required.
  • If you would like to use a payment plan, select "pay in McComas" during the payment process of online registration. The payment dates will be decided when you come to McComas to pay the first installment.
  • Please bring a towel and water bottle to each session.
  • Students may use McComas Hall or Hokie Gym. Faculty/Staff clients must use Hokie Gym. See facility policies.
* I agree to the above policies.


Informed Consent

I, being aware of my own health and physical condition, and having knowledge that my participation in the Recreational Sport's Personal Training Program may cause injury, am voluntarily choosing to participate in the program. The Personal Training Program is a program designed to guide me, safely and effectively, through an appropriate individualized fitness/exercise regime based on my initial fitness assessment and goal assessment. Following an initial fitness assessment and completion of a health history form and possibly a doctor's note, I will be given an individual exercise program that focuses on increasing fitness to prepare me for normal activities of daily living.

I acknowledge that I have the option to discontinue any activity at my own discretion. I also acknowledge that all information obtained about myself through this program will be kept in strict confidence within the Personal Training Program.  All confidential information will be managed through the Virginia Tech Records Management Department.

I agree that I am providing accurate answers to the following questions regarding my health history:

Yes No  

Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes No  

Do you feel pain in your chest when you do physical activity?

Yes No  

In the past month, have you had chest pain when you were not doing physical activity?

Yes No  

Do you lose your balance because of dizziness or do you ever lose consciousness?

Yes No  

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Yes No  

Is your doctor currently prescribing drugs (for example, water pills) for your blood pressure or heart condition?

Yes No  

Do you know of any other reason why you should not do physical activity?

Having such knowledge, I hereby release Recreational Sports, all of its employees and sponsors from liability for accidental injury or illness that may occur as a result of participation in the fitness program. I hereby assume all risks connected therewith and consent to participate in the Personal Training Program.

* I agree to the above terms. I agree to have a Medical Release Form completed by my physician and faxed to the Recreational Sports Office before beginning exercise if any of the above 7 health questions are answered "Yes." [Medical Release Form]

Payment Method *
Indicate your Selection
Pay in person at the Recreational Sports Office in 142 McComas Hall (select this if using a payment plan)
Pay online with Credit Card (Visa or MasterCard accepted)
 

If paying online, Enter the account holders name as it appears on the Credit Card:




Virginia Tech Department of Recreational Sports
142 McComas Hall
Blacksburg, VA 24061-0358
540-231-6856

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