Personal Training Request Form Webform Personal Training Request A valid DFC membership is required to work with a trainer. Please select the option that applies to you. - Select -I am a current memberI'm considering a membership 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? (note: swim sessions may only occur during M-F evening and weekend Rec Swim) How many times per week would you like to work with a trainer? Type of training you are requesting - Select -Individual TrainingPartner TrainingGroup Training (3-5 people) Indicate if you are requesting swim training. (If you are interested is Youth Swim Lessons, please visit our Youth Swim Lessons section) Partner or Group Member Names (each participant must submit a request form) Your fitness goals and objectives Describe your general fitness level/experience If you have worked with a trainer previously, please describe your experience. Describe your current physical activity or exercise habits. Anything else we should know? (special considerations, favorite activities, etc.) 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. I hereby certify that I have read, understand, and accept the policies of the Personal Training Program. Submit
