Skip to main content
User account menu
Donate
Membership
Careers
YMCA360
Main navigation (mobile)
About
About the YMCA
Leadership
Diversity
Nourish
Rentals
Work at the Y
Volunteer
Contact Us
Membership
Rates & Benefits
Financial Assistance
Refer a Friend
My Account
Locations & Hours
All Locations
53rd Street YMCA
Bass Street YMCA
Rock Island YMCA
Kewanee YMCA
Golf Range
Schedules
Programs & Classes
Sports & Recreation
Adult Sports
Youth Sports
Golf Learning Center
Y Quad Cities Rowing
Child Care & Camp
Summer Day Camp
School Age Childcare
Preschool
Youth Development
Kid's Adventure Center
Aquatics
Swim Lessons
Lifeguarding
Aquatic Group Exercise
Advanced Swim
Our Pools
Exercise & Wellness
Group Exercise Classes
Personal Training
Chronic Disease Prevention
Wellness Programs
Workout Centers & Gyms
Virtual Classes
Family Programs
Homeschool
Kids Night Out
STEM Programs
Get Connected
Social Media
Blog
Events
Contact Us
Email
YMCA Merchandise
Two Rivers YMCA
User account menu
Donate
Membership
Careers
YMCA360
Main navigation
About
About the YMCA
Leadership
Diversity
Nourish
Rentals
Work at the Y
Volunteer
Contact Us
Membership
Rates & Benefits
Financial Assistance
Refer a Friend
My Account
Locations & Hours
All Locations
53rd Street YMCA
Bass Street YMCA
Rock Island YMCA
Kewanee YMCA
Golf Range
Schedules
Programs & Classes
Sports & Recreation
Adult Sports
Youth Sports
Golf Learning Center
Y Quad Cities Rowing
Child Care & Camp
Summer Day Camp
School Age Childcare
Preschool
Youth Development
Kid's Adventure Center
Aquatics
Swim Lessons
Lifeguarding
Aquatic Group Exercise
Advanced Swim
Our Pools
Exercise & Wellness
Group Exercise Classes
Personal Training
Chronic Disease Prevention
Wellness Programs
Workout Centers & Gyms
Virtual Classes
Family Programs
Homeschool
Kids Night Out
STEM Programs
Get Connected
Social Media
Blog
Events
Contact Us
Email
YMCA Merchandise
Personal Training Form
Name
Email
Phone
Type of training
Individual Personal Training
Partner Personal Training
FUEL + Fitness
FUEL only
InBody
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.