Name
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First Name
Last Name
Email
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Phone
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(###)
###
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Age
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Current Height and Weight (lbs)
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If you are unsure, provide an estimate. This information will be kept private.
Do you identify as trans or non-binary
Yes
No
I'm not sure
How would you describe your current fitness level?
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Just starting out – getting back into the swing of things
Moderate – I’m fairly active and work out occasionally
Advanced – I work out regularly and am in pretty good shape!
1. What’s your main goal for joining the boxing program?
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Select 1
What do you want to achieve at the end of your training?
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Boxing provides a wide range of mental, emotional, and physical benefits. What is the measurable progress you want to see? Examples: weight loss goal, improvement in functional strength, increased athleticism, stress relief, practical fighting skills, etc.
What’s your boxing experience so far?
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Select all that apply.
Tell me more about your previous boxing/personal training experience.
Do you have sparring experience?
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Yes
Not yet, but I'm ready to try it
No, and I’m not interested in sparring (at least not right now)
Huh?!
What’s your preferred availability?
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List preferred days and times for training)
Do you have any injuries or health conditions I should know about?
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(Include anything from recent injuries to long-term conditions that might affect your training)
Are there any specific needs, sensitivities, or concerns you'd like me to know about that would help make your training experience comfortable and affirming?
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{This could include things like preferences around bathroom or locker room use, anxieties about being “clocked,” discomfort with physical touch during training, or anything else related to personal safety and comfort. Feel free to share as much or as little as you're comfortable with.)
How did you hear about my training program?
Directly from me
Referred by a friend
Social Media
Other