Personal Training Request Form In compliance with the University's health precautions concerning COVID-19, the Dodge Fitness Center is now CLOSED. Webform Personal Training Request I hereby certify that I have read, understand, and accept the policies of the Personal Training Program. Email Name First Last Phone Number Age and DOB Gender Columbia Affiliation - Select -UndergradGraduate StudentAlumnFaculty/StaffFamily MemberNeighbor Preferred Trainer What is your availability for training? How many times per week would you like to work with a trainer? Type of training you are requesting - Select -Private TrainingPartner TrainingGroup Training Length of session - Select -50-minutes30-minutes Partner or Group Member Names (if applicable) Your fitness goals and objectives Your previous fitness experience If you have worked with a trainer previously, please describe your experience. Describe your current physical activity or exercise habits. List any favorite physical activities or exercises. I agree to the terms of service. Information Confidentiality The Columbia University Personal Training Program classes provide vigorous recreational exercise; prior exercise is presumed. If you are new to exercise or have any doubts as to your readiness to participate in an activity, you should consult your physician, the Program Director and/or your trainer. Like any activity, exercise has its risks. While trainers are intent upon preventing and minimizing the chances of these problems occurring, primary responsibility for your safe participation remains with you. Once in a session, if you experience pain, discomfort, or anxiety, stop exercising and consult with your trainer or Program Director. Any questions which may have occurred to me have been answered to my satisfaction. I understand that all information collected regarding my participation in this program will be held in strict confidence by the Physical Education staff. Submit