Form Center

2. Client Registration Form

   Client Registration Packet and PAR-Q form must be completed and submitted to the Fitness Supervisor prior to the first session. New clients must purchase first session prior to scheduling. The Town of Castle Rock staffs a team of nationally-certified and experienced personal trainers. They are here to help you successfully and safely reach your fitness goals. Each has extensive knowledge in many areas of fitness and is an expert in providing clients with individualized and effective workout programs.

4. Type of training that you are registering for:*

   1. Personal Training

   1. Pilates/Reformer Training
6. Private Personal Training (Select the number of sessions you are looking for)

   Personal training can help you achieve your goals regardless of your age or fitness level. A trainer will design a program to meet your individual needs. This one-hour session will be tailored to your specific goals. Ages 12 and up.

   1. Individual Session

   1. Three Sessions

   1. Six Sessions

   1. 10 Sessions
8. 30-Minute Express Sessions (Select the number of sessions you are looking for)

   Whatever your goal, this quick session will support your busy schedule and accommodate your need for results. These 30-minute sessions are tailored to your specific goals. Ages 12 and up.

   1. Individual Session

   1. Three Sessions

   1. Six Sessions

   1. 10 Sessions
10. Buddy/Group Personal Training

    Buddy training allows you and a friend to work together towards your fitness goals. This one-hour session will be tailored to your specific goals. Ages 12 and up. Groups of two or three.

    1. Buddy Session (two people)

    1. Group Session (three people)
12. Buddy/Group Express Sessions

    Buddy training allows you and a friend  to work together towards your fitness goals. These 30-minute sessions are tailored to your specific goals. Ages 12 and up. Groups of two or three.

    1. Buddy Session (two people)

    1. Group Session (three people)
14. Private Reformer Training

    Private Reformer Training is one-on-one instruction that can help you achieve your goals regardless of your age or fitness level. Trainers will assess your alignment and posture to design a workout specifically for you. Ages 16 and up

    1. Individual Session

    1. Three Sessions

    1. Six Sessions

    1. 10 Sessions
16. Buddy Reformer Training

    Buddy training allows you and a friend to work together towards your fitness goals. This one-hour session will be tailored to your specific goals. Prices listed are per group. Ages 16 and up. Groups of two or three.

    1. Buddy Session (two people)

    1. Group Session (three people)
18. Client Confidentiality
    Information will not be released without the individual’s permission, except in emergency situations. Regular evaluation of your trainer’s performance and your progress will be completed using written and verbal communication with your trainer and our fitness staff. If you have any feedback regarding your trainer or the program, please contact the Fitness Supervisor at 303-814-7453.
20. Fitness Division-Fitness Area Guidelines*

    The Town of Castle Rock is responsible for operating its recreational facilities and all related programs in a professional, safe and enjoyable manner for all patrons. In order to ensure this standard while training, the following guidelines have been established. Please check each guideline acknowledging your understanding and acceptance.

    1. Appropriate athletic footwear is required in all fitness areas for your safety. Sandals and open-toed shoes are not permitted.
    2. Shirts are required in all fitness areas.
    3. Machines and weights are to be used with care. Dropping weight plates, dumbbells or bars can cause injury, equipment damage and/or facility damage and is not permitted.
    4. All equipment is to be returned back to proper locations after use.
    5. Be respectful of other patrons.
    6. Keep personal music devices at an appropriate volume level.
    7. Food is not allowed in any fitness area. Water is the only permitted beverage.
22. Personal Information
24. First Name*
25. Last Name*
27. Age/DOB*
28. Email*
30. Gender*

    1. Male
    2. Female
31. Height*
32. Weight*
34. Address1*
36. Address2
38. City
39. State
40. Zip
42. Daytime Phone*
43. Evening Phone
45. Emergency Contact Information
47. Name*
48. Relation*
50. Home Phone
51. Cell Phone
53. How did you learn about the Castle Rock Recreation Center’s Personal Training services?

    1. Recreation Guide
    2. Friend

    1. Town Website
    2. Other (please explain)
54. Other explanation:
56. Training Preferences and Availability: (Trainer bios are available online at www.crgov.com or at the Recreation Center)
    My preferred trainer is: (optional)
58. Please indicate the days and times you are available and prefer to train.

    Please be specific, the more flexible your time, the easier it is to match you with a trainer.

60. Monday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
62. Tuesday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
64. Wednesday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
66. Thursday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
68. Friday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
70. Saturday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
72. Sunday

    1. Yes

    1. No

    1. A.M.

    1. P.M.
74. Please indicate your current levels of satisfaction in the following areas:
    (1 being Very Dissatisfied, and 10 being Very Satisfied)
76. Weight
    -- Select One --12345678910
77. Body Composition
    -- Select One --12345678910
78. Physical Activity Level
    -- Select One --12345678910
79. Use of Tobacco
    -- Select One --12345678910
81. Blood Pressure
    -- Select One --12345678910
82. Cholesterol
    -- Select One --12345678910
83. Muscular Strength & Endurance
    -- Select One --12345678910
84. Cardio Endurance
    -- Select One --12345678910
86. Stress Levels
    -- Select One --12345678910
87. Nutrition Habits
    -- Select One --12345678910
88. General Lifestyle
    -- Select One --12345678910
90. What goals would you like to achieve from participating in personal training services? *
92. Medications/Allergies
94. Please list any medical concerns/conditions that might limit your ability to participate in personal training services (pregnancy, disability, chronic conditions etc.):*
96. Please list any known allergies (environmental, medications, food, etc.):
98. Please list current medications including over-the-counter medications, prescriptions, etc. that may affect your body’s response to exercise. Please include dosage and what it is for.
100. Exercise History and Attitude
102. 1) Have you been involved in a routine of regular aerobic exercise ?*

     (moderate, continuous activity for at least 15-20 minutes duration, at least 3 days per week)

     1. Yes

     1. No
104. If yes, for how long and what activities?
106. If no, when was the last time you recall being active for at least 20 minutes? What activity were you doing?
108. 2) Are you currently involved in a weight training and conditional program ?

     1. Yes

     1. No
110. If yes, please explain/summarize your current program .
     (exercises, free weights, goals, etc.)
112. 3) Check the activities you would consider doing:

     1. Walking
     2. Group Fitness Classes
     3. Strength Training
     4. Rowing
     5. Swimming

     1. Running
     2. Cycling
     3. Cardio Machines
     4. Athletic Drills
     5. Other (please explain)
114. Other (explanation):
116. Terms and Conditions*

     I agree to adhere to all Town of Castle Rock Parks and Recreation’s personal training and general fitness policies and procedures.

     1. Accept
118. Training Policies and Guidelines*

     In order to help make your personal training experience a positive one, we have established the following policies. Please check each policy signifying your knowledge of and agreement with each policiy

     1. Client Registration Packet and Par-Q form must be completed prior to the first session.
     2. New clients must purchase sessions prior to the first scheduled session.
     3. Trainers cannot take session payments. Please purchase sessions at the Recreation Center front desk.
     4. Call your trainer or the Recreation Center front desk if you know you are running late to a scheduled session. Trainers will wait 15 minutes and then the scheduled session will be forfeited.
     5. If needed, sessions must be canceled or rescheduled 24 hours in advance or the session will be forfeited. Call your trainer directly to reschedule your appointment.
120. Please check all that you agree to: *

     1. All patrons agree to abide by the Town of Castle Rock’s facility rules and regulations and Code of Conduct while in the facility. These rules and regulations may change from time to time.
     2. Patrons must check in at the front desk.
     3. Patrons wishing to use the facility before or after a schedule session must pay the daily admission or use their pass.
     4. If my health status changes after completing the registration packet, I will inform my trainer immediately. I understand that I may need to obtain a physician’s clearance prior to continuing training
     5. All sessions must be used within 1 year of purchase date.
122. Electronic Signaure:*
     Please type your First and Last Name. Typing your name above constitutes a legal signature whereby you are confirming the information provided in this form is true and correct to the best of your knowledge, that you are a parent or legal guardian of the participant, and that you acknowledge and agree to the above Waiver for Participation and Personal Release Statement.
123. Guardian Signature
     Required if participant is under the age of 18
125. Date
     Date
Leave This Blank:


127. 1. Receive an email copy of this form.
128. Email address

     This field is not part of the form submission.

129. Submit

* indicates a required field