Registration Form Registration Form Name *Email Address *PhoneWhat are your fitness goals? Please be as specific as possible. *What product are you interested in?1 on 1 Custom ProgrammingPre-Made ProgramsTeam/Group ProgrammingYou can message us which Pre-Made Program you are interested in within the Trainerize app.Please describe in detail what equipment you will have access to. (Barbells – Squat Rack, Bench Press, Dumbbells, Cable Machine (Rows, Pulldowns, etc.), Other Machines (Chest Press, Leg Press, Seated Leg Curls, etc.) *Please be sure to include weight limitations for free-weights, such as barbells, dumbbells and kettlebells.Please list any injuries or physical limitations you haveThis is important as it will help us factor OUT any exercises you can NOT do.Please highlight your training history.What kind of workouts have you done in the past? What splits you have followed? Highlight your past routines. Feel free to be as detailed as possible.Please specify how many days a week you would like to train, and which days specifically.This is important as it helps us schedule your workouts appropriately.What training split are you looking to follow?If you’re unsure, you can leave this blank.Which exercises do you absolutely love and absolutely hate doing?We will keep this in mind while programming for you.I acknowledge that in order to reach my health and fitness goals, I must take full responsibility for my health and wellness. I understand that Optimal Programming LLC solely provides guidance within the gym, and my progress is built upon both discipline and habits inside and outside of the gym. *By clicking here, I acknowledge the above statement.I have read the PRIVACY POLICY, TERMS AND CONDITIONS, WAIVER AND LIABILITY AND PARQ. *Yes, I agree with the privacy policy and terms and conditions. I have read the Waiver and Liability, and SUBMITTING THIS FORM releases Optimal Programming LLC from any and all liability. I understand there are inherent risks involved with exercise, and do so voluntarily. I have read the PARQ and deemed myself fit and healthy for exercise. If I do not agree with any of the above statements, I will NOT submit this form and will contact Optimal Programming LLC via email at optimalprogramming@gmail.com directly. Otherwise, by submitting this form I am ready to start training!Send Message