Gym Personal Trainers
NDIS Personal Training & Exercise Provider
Mobile Personal Training
New Client PT Questionnaire
NDIS Exercise Physiology
Book a Consultation
Sports & Injury Physiotherapy
Women’s Health Physio
Physio Clinical Pilates
Group Fitness / Boot Camps
About Our Group Training
Group Training Timetable
Massage Therapy / Remedial Massage
Other Health Services
DVA – Veterans Exercise
NDIS Participants – Capacity Building
TAC Patients – Exercise & Physio
Our Local Community
Meet The Team
Meet The Team
Back In Motion – FORM
- Contact Information
Date of Birth:
ZIP / Postal Code
Mobile Phone Number:
Home Phone Number:
Work Phone Number:
Emergency Contact Details:
Emergency Contact Name:
Please check the box to the left of the condition if you have any of the following:
Family History of Heart Disease
High Blood Pressure
Shortness of Breath
Irregular/Accelerated Heart Rate
Back Pain/Spine Disorder
Are you over 50 and not used to being active?
Are you taking any Medications, pills, tablets or supplements that may effect your training?
If Yes, please list or describe your current medication.
Do you have any current injuries or have you suffered any serious injuries in the past?
If Yes, please give a breif description of the injuries.
Current Health & Fitness
Please select your health & fitness goals:
Toning + Definition
Sport Specific Conditioning
Injury Rehabilitation + Recovery
Please briefly describe the other health & fitness goals you have.
Do you smoke?
Please briefly describe your smoking history. (How long, how often, have you tried to quit)
Have you ever done Personal Training, Group Training or Bootcamps in the past?
Yes - Personal Training
Yes - Group Training
Yes - Bootcamp
Describe your past invovlement with Personal Training, Group Training and Boot Camps. (Where, when, likes / dislikes)
What types of exercises and training do you enjoy?
Mix of everything
How many days a week are you currently working out? (0-7)
0 - None at the moment
1 - One day a week
2 - Two days a week
3 - Three days a week
4 - Four days a week
5 - Five days a week
6 - Six days a week
How long are your typical workouts? (ie. 30min weights, 30min cardio, 60min walking, ect)
How many days a week would you realisitcally like to see yourself working out?
Once a Week
Twice a Week
Three times a week
Four times a week
Five times a week
Six times a week
Describe your ideal Personal Trainer (personality, type of trainer, special interests / expertise ect.)
Are you happy with your current eating habits and nutrition?
If No, what part of your eating habits do you struggle with? Eg. Meal selection, portion sizes, sweet tooth
Do you require assistance with your diet?
Please read through our contract agreement and cancellation policy for all our Personal Training clients.
Agreement & Cancellation Policy
I am aware that if I need to cancel or reschedule my personal training sessions I must contact my trainer 24 hours prior to the session otherwise I will be charged for the session.
I am aware that if I wish to cease my training relationship with
Max NRG Personal Training Pty Ltd.
'Moonee Valley Health and Fitness'
, I am required to give 2 weeks written notice.
I agree to the Agreement & Cancellation Policy
Terms & Conditions
I wish to participate in the activities and programs of
Max NRG Personal Training Pty Ltd
ABN 48 045 374 949 trading as
'Moonee Valley Health and Fitness'
I understand that:a) Portions of the exercise and training program may occur outdoors.b) Exercise carries some risk including, without limitation, risk to the musculoskeletal system and to the cardio respiratory system.
In consideration of Moonee Valley Health and Fitness agreeing to provide training and fitness activities and programs, I release Max NRG Personal Training Pty Ltd, its employees and representatives from any and all responsibilities or liability from injuries or damages resulting from or ancillary to my participation in any activities or my use of the equipment.
I understand and am aware that strength, flexibility and aerobic exercise, including the use of equipment is a potentially hazardous activity. I also understand that fitness activities involve a risk of injury or death, and that I am voluntarily participating in these activities and using equipment with knowledge of the dangers involved. I agree to expressly assume and accept any and all risk of injury or death.
I agree that I have no undisclosed injury or illness that may affect my ability to undertake rigorous exercise and to the best of my knowledge I are ready and able to undertake this exercise program.
I also acknowledge that it has been recommended that I have a yearly or more frequent physical examination and consultation with my physician as to physical activity exercise and use of exercise and training equipment, so that I might have his/her recommendations concerning these fitness activities and equipment use.
I acknowledge that I have either had a physical examination and been given my physician’s permission to participate, or that I have decided to participate in the activity and use of the equipment without the approval of my physician and assume all responsibility for my participation in activities, and utilisation of equipment in my activities.
Finally, I acknowledge and agree that no warranties or representatives have been made to me by any representative of Moonee Valley Health and Fitness regarding the results I will or may achieve from any program conducted at Moonee Valley Health and Fitness. I understand that results are individual and may vary.
I agree to the terms
Bootcamper - New Starter Email Series
This is for all new clients
Speak to the MVFit Trainer Team Today
Getting Started Changes Everything - contact us