Request Personal Training Information

Please complete the following form and click the "Send Request" button.

The WAC will respect and maintain your privacy with the following information.

Contact Information

How should we contact you ?

Member Facility

Information Requested

Do you have any health risks that the Personal Trainer should be made aware of? (i.e. Previous heart condition, high blood pressure, asthma, pregnancy, joint problems, previous surgeries, etc.)

Email if you experience problems filling out this form -or- a delayed response from the clubs.

Please note: Security check below is case sensitive. To generate a new security code - click the blue circle with grey arrows (next to code).

* Bold Fields are Required