Personal Training Application Packet

Training Package Pricing

Personal Information


MM/DD/YYYY






Training Package Options

Please select the package you would like to purchase




For Office Use Only





Personal Training Policies

The Providence College Personal Training Program is available to all students and CFC members. Our nationally certified personal trainers can provide you with the education and instruction you will need to reach your health and fitness goals. You can meet with a certified personal trainer, one-on-one or with a buddy. Your Personal Trainer will design and guide you through a personalized fitness regimen. Sessions are one hour in length.

Scheduling:

To schedule your initial session:

  1. Complete this form and return when you pay for your training package.
  2. Register and pay for package at the Concannon/Peterson Office Monday through Friday 8:30am – 4:30pm.
  3. Schedule your training sessions by calling or emailing Susan Gibree at 401.865.2350 or sgaber@providence.edu

All scheduling, rescheduling or cancellation of Personal Training Services should be done through the Fitness Director, Susan Gibree at 401.865.2350.

Cancellation/Rescheduling Policy

If you need to cancel or reschedule a session, please call Susan Gibree at 401.865.2350. If she is not in, be sure to leave her a message. She will check the availability of your trainer and get back to you with confirmation of the rescheduled date and time. If it is a last minute emergency and you have your instructor's telephone number, please call the instructor directly.

24 hours' notice is required for cancellation or rescheduling to receive credit for the session. Failure to cancel within this time frame or failure to show up for a session will result in the client being charged for the session. Exceptions will only be made in the case of a medical emergency accompanied by a doctor's note.

If you cancel more than three times without 24 hours' notice we reserve the right to terminate the remainder of your personal training sessions.

Tardiness Policy:

Clients are expected to begin working out at the start time of the scheduled appointment. A late start time does not entitle a client to a session longer than the scheduled appointment.




Health History Questionnaire









BOX 1 - Medical History
Do you have a history of the following?









Do you have any of the following symptoms?





BOX 2 - Risk Factors

BOX 3 - Additional Health Information

List all medications you take on a regular basis:

Medications



Informed Consent and Waiver

I understand that I may be undergoing physical exertion while participating in services and activities at or associated with the Concannon/Peterson Fitness and Recreation Center and I certify that my level of physical fitness is sufficient for the activities in which I choose to take part. In acknowledging that I am aware of and willing to assume the risks associated with these activities and services, I hereby voluntarily agree to waive, hold harmless and indemnify Providence College and its agents, volunteers and employees from any and all claims, demands, damages and causes of action of any nature whatsoever arising out of ordinary negligence which I, my heirs, my assigns or successors may have against them for, on account of, or by reason of my voluntary participation in services and activities at or associated with Providence College and Recreation Center. I understand the content of this document, and I execute this INFORMED CONSENT AND WAIVER OF CLAIM FORM of my own free will and accord.






Required if participant is under 18

Personal Training Interest Form

Please check your Availability: (this is not final)

SunMonTueWedThuFriSat
6:00 AM
7:00 AM
8:00 AM
9:00 AM
10:00 AM
11:00 AM
12:00 PM
1:00 PM
2:00 PM
3:00 PM
4:00 PM
5:00 PM
6:00 PM
7:00 PM
8:00 PM
9:00 PM
10:00 PM
11:00 PM
For administrative use only: