Training Service Interest Form

Thank you for taking the first step toward working with one of our certified personal trainers. Whether you are new to fitness or have years of experience, our trainers bring the expertise, knowledge, and enthusiasm to guide you toward your fitness and wellness goals.

Please complete this form so we can match you with the trainer best suited to your needs. Once your form is submitted, a member of our professional staff will contact you to schedule your initial consultation.

Training Services Interest Form

Before we begin this journey together, we need additional information from you about your health history, preferences, and motivations. This form will allow our nationally accredited trainers to best craft your consultation appointment to your specific needs and goals.

This interest form will prompt you to provide the following information: Personal information, emergency contact information, personal and family health history, lifestyle and exercise history, and next step preferences.

If you have any questions, please feel free to reach out to the Fitness Coordinator, Natasha Nienhuis, at [email protected].

Personal Information

First Name *

Last Name *

GVSU ID

Gender

Pronouns

GVSU Affiliation *

Email *

Email (Confirmation)

Phone *

Preferred Method of Communication *
Emails
Phone Calls
Text Messages

Emergency Contact

First Name *

Last Name *

Relationship *

Email *

Email (Confirmation)

Phone *

Health History

Have you had, or do you presently have any of the following? Select all that apply. *
Chest discomfort with exertion
Unreasonable breathlessness
Dizziness, fainting, blackouts
Ankle swelling
Unpleasant awareness of a forceful, rapid or irregular heart rate
Burning or cramping sensations in your lower legs when walking short distance
Known heart murmur
I have not experienced or currently am experiencing any of the above signs or symptoms.

Have you performed planned, structured physical activity for at least 30 min at moderate intensity on at least 3 days per week for at least the last 3 months? *

Have you had, or do you presently have any of the following? Select all that apply. *
Heart attack
Heart surgery, cardiac catheterization, or coronary angioplasty
Pacemaker/implantable cardiac defibrillator/rhythm disturbance
Heart valve disease
Heart failure
Heart transplantation
Congenital heart disease
Diabetes
Renal disease
None of the above.

Next Steps

Please indicate your desired number of training sessions per week. *

Please indicate the days per week that you would be available to train. It should be noted that sessions can range from 30-minutes to 60-minutes in length. *
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Sunday

Please indicate the times you would be available on a Monday. *

Please indicate the times you would be available on a Tuesday. *

Please indicate the times you would be available on a Wednesday. *

Please indicate the times you would be available on a Thursday. *

Please indicate the times you would be available on a Friday. *

Please indicate the times you would be available on a Saturday. *

Please indicate the times you would be available on a Sunday. *

What training services are you interested in participating in? *
Personal Training
Small Group Training
Anchor Into Fitness

For small group training, please select the scenario that best fits your needs: *

Please share all the names and email addresses for your pre-selected SGT teammates: *

Training Services Acknowledgement of Risk and Release of Liability

Purpose: The purpose of your Personal Training, Small Group Training and/or Anchor Into Fitness program is to assist you in establishing/increasing/maintaining positive exercise behaviors as well as improving health-related physical fitness. Your individual exercise program will be designed based on your interests, current self-reported fitness level, and the exercise equipment you have available.

Acknowledgment of Risk and Release of Liability: I hereby declare, assert, and affirm that my participation in the Grand Valley State University Recreation and Wellness Personal Training, Small Group Training and/or Anchor Into Fitness program, is done having voluntarily and knowingly assumed all risks involved in this event. The immediate physical risk(s) associated are those correlated with normal, vigorous physical activity. These risks include, but are not limited to, bodily discomfort and fatigue, muscular soreness, pulled or strained muscles, overuse injuries/soft tissue damage, bodily injury resulting from falls, and the rare instance of abnormal changes/responses of the cardiopulmonary system to exercise. Adverse responses include abnormal blood pressure, heart arrhythmias, and the very rare instance of heart attack, stroke, or sudden death. Before starting any fitness program, you should consult your physician or other health care professional to determine if it is right for your needs.

In consideration of acceptance of this contract allowing my participation in the above stated program and intending to be legally bound thereby, I hereby for myself, my heirs, executors, administrators, and assigns, WAIVE AND RELEASE any and all rights and claims for negligence, injuries, damages, equipment, facilities, staff training, or losses that I may incur involved in the above stated Recreation & Wellness program, specifically Grand Valley State University, its respective employees, agents, representatives, successors, and assigns for any and all activities connected with the above stated program. If I am a Grand Valley employee (faculty or staff member), I also understand that I do hereby WAIVE any and all rights or benefits under the State of Michigan Worker’s Compensation laws for any injury incurred as a result of my participation in this event.

Training Services Policy

No-Show & Late Cancellation Policy

Clients must cancel or reschedule appointments at least 24 hours in advance. Cancellations made less than 24 hours before the scheduled session will be considered late cancellations and will result in a session charge. Failing to attend a scheduled session without prior notice will also result in a session charge.

Late Arrival

If clients are more than 15 minutes late, the session may be shortened or canceled at the trainer’s discretion and will still be charged in full. The session will end at the originally scheduled time to avoid affecting the next client’s session.

Refund Policy

A refund request must be submitted through the Recreation & Wellness Refund Request Form. It may take up to 4 weeks to process. All refunds are subject to a 25% processing fee. If the registration fee is over $50, processing fee will be a flat fee of $10. If payment was made by credit card, the refund is returned to the original credit card. If the refund request is denied, an explanation as to why it was denied will be provided. Refunds cannot be guaranteed if requested beyond 30 days from the original transaction date.

Acknowledgment of Understanding *
I have read, understand, and agree to all of the above statements.

Signature *

By signing below, you affirm that you have read, understand and agree to all of the above statements.

Human Verification *

Page last modified July 16, 2026

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Training Service Interest Form