Skip to main content
User account menu
Donate
Membership
Careers
YMCA360
Main navigation (mobile)
Programs By Age
Parent Child (0-2)
PreSchool (3-5)
Elementary (6-10)
Middle School (11-14)
High School (15-18)
Adult/Senior (18+)
Programs
SPORTS AND TEAMS
Adult Sports
Youth Sports
Golf Learning Center
YMCA Quad Cities Rowing
Flip Tops Gymnastics Team
Kraken Swim Team
CHILD CARE AND CAMPS
Summer Day Camp
Summer Sports Clinics
Before and After School
Schools Out Club
Preschool
Y Winners
SWIMMING
Swim Lessons
Lifeguarding
Aquatic Group Exercise
Advanced Swim
Our Pools
HEALTH & WELLNESS
Group Exercise Classes
Chronic Disease Prevention
Wellness Programs
Wellness Centers & Gyms
Personal Training
ADDITIONAL EXPERIENCES
Kid's Adventure Center
Homeschool
Kids Night Out
STEM Programs
Schedules
Locations
All Locations
Moline-East Moline YMCA
Rock Island YMCA
Kewanee YMCA
Bass Street YMCA
Golf Learning Center
Spirit, Mind, & Body Center
Riverside Riverslide
Membership
Mission
Careers
Two Rivers YMCA
User account menu
Donate
Membership
Careers
YMCA360
Main navigation
Programs By Age
Parent Child (0-2)
PreSchool (3-5)
Elementary (6-10)
Middle School (11-14)
High School (15-18)
Adult/Senior (18+)
Programs
SPORTS AND TEAMS
Adult Sports
Youth Sports
Golf Learning Center
YMCA Quad Cities Rowing
Flip Tops Gymnastics Team
Kraken Swim Team
CHILD CARE AND CAMPS
Summer Day Camp
Summer Sports Clinics
Before and After School
Schools Out Club
Preschool
Y Winners
SWIMMING
Swim Lessons
Lifeguarding
Aquatic Group Exercise
Advanced Swim
Our Pools
HEALTH & WELLNESS
Group Exercise Classes
Chronic Disease Prevention
Wellness Programs
Wellness Centers & Gyms
Personal Training
ADDITIONAL EXPERIENCES
Kid's Adventure Center
Homeschool
Kids Night Out
STEM Programs
Schedules
Locations
All Locations
Moline-East Moline YMCA
Rock Island YMCA
Kewanee YMCA
Bass Street YMCA
Golf Learning Center
Spirit, Mind, & Body Center
Riverside Riverslide
Membership
Mission
Careers
Personal Training Form
Name
Email
Phone
Type of training
Individual Personal Training
Partner Personal Training
Group Personal Training
InBody
Nutrition Coaching
Age Group
18 or under
19-29 years old
30-39 years old
40-49 years old
50-59 years old
60-69 years old
70 years or older
Gender
Male
Female
Prefer not to specify
How often would you like to train per week?
One day
Two days
Three days
Preferred Day(s)
Preferred Times(s)
What goals do you have?
Do you have any injuries, illnesses, or health conditions that require special attention?
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.