health

Name *

First

Last

AGE *

Sex *

Female Male

Email *

Emergency Contact Name *

First

Last

EMERGENCY Contact Phone Number *

Do you have a friend, family member or coworker who you think maybe interested in Training? Please list their name *

Current Weight *

Using the Image Above Please Estimate your current level of Body Fat *

Program Structure: Our sessions are 30 minute Semi Private training with a MAX of 6 people to 1 Trainer. Each person will receive individual attention based on your goals. Sessions also begin promptly at their scheduled time. If you are late there is no make up time. *

Refunds: I understand and agree that there are absolutely NO REFUNDS. I understand and agree that all sessions will NOT rollover. Failure to complete total sessions within the 28 day billing cycle will result in the forfeit of any remaining sessions and no refunds will be given for any remainder sessions. Sessions are NOT transferable. *

12 Month Agreement- If you have to cancel for whatever reason during your 12 months There is a penalty of $300 that is due and you must let us know 30 DAYS PRIOR to your next billing cycle. Send us an email with "Cancellation" in the subject line. We will reach out to you to set up a phone call to go through the procedure. After 12 Months your contract will roll into a Month to Month at your current rate.

Agreed *

“I acknowledge that I am making this commitment to myself and to AB Fitness & Nutrition Inc. I will not quit before the end of this commitment, I expect AB Fitness to hold me accountable to completing this commitment, and I agree to give my best and assume full financial responsibility for this commitment.” (Please Initial Below) *

Call or Text Us to Get Started- 516-229-1438

We have Two Locations..They are located:

East Meadow Personal Training Studio
514A East Meadow Ave
East Meadow NY 11554

Massapequa Personal Training Studio
4150C Merrick Road
Massapequa NY 11758

DISCLAIMER: All diet, nutrition and training information contained herein is provided for informational purposes and is not meant to substitute for the advice provided by your own physician, dietician or other medical professional. You should not use the information contained herein for diagnosing or treating a health problem or disease. This information is not intended to diagnose, treat, cure, mitigate or prevent any disease, medical problems or substitute for appropriate medical care. Consult your physician with questions before starting this or any nutrition, exercise, diet or dietary supplement program. Anthony Bevilacqua assumes no liability for any injury, death, personal loss or illness caused by any information contained herein. These claims have not been clinically proven or evaluated by the FDA. Results may vary.

The dramatic weight loss and other health related experiences depicted here are not typical, are self reported and applicable only to these individuals. You should not expect to achieve similar weight loss- these results are truly extraordinary. Anthony Bevilacqua teaches habit modification, increased exercise, proper eating and long term maintenance to achieve a desired result.

YOUR CART

Health Questionaire/ Intake Form

Health History

AB Fitness Center Personal Training Rules & Agreement

WE ARE SUPER EXCITED TO WORK WITH YOU!!!

Call or Text Us to Get Started- 516-229-1438