HARVARD RECREATION Fitness Services Request Form Fitness Services are available at the Hemenway Gymnasium Located at 1515 Massachusetts Avenue and the Malkin Athletic Center located at 39 Holyoke Street. Which facility would you prefer? (Please check one) Malkin Athletic Center Hemenway Gymnasium Either facility is fine Date__________________ Name_____________________________________ Telephone Number _____________________ Email ____________________________________ Affiliation with the University: (circle one) undergraduate graduate student faculty/staff Date of Birth ________________________ alumni Gender (circle one) partner/family member Male Female Fitness Service(s) You Are Interested In: (circle all that apply) Fitness Assessment Equipment Orientation Personal Training If you are interested in Personal Training and have a preferred trainer, please list the trainer’s name _____________________________________________ Fitness Goals (be as specific as possible) __________________________________________________________________________________________________ Available Days: Mon Tues Wed Thurs Fri Sat Time(s) preferred: _____________________________________________ How did you hear about our Fitness Services? (circle all that apply) website facebook Referral from a friend or rec staff signage at the facility who referred you?: ___________________________ A variety of fitness services are available to best suit your needs including: Equipment Orientations – an introduction to the weight machines and cardio equipment (45 minutes) Fitness Assessments – have your current fitness levels assessed with recommendations made by a trainer (30 minutes) One on One Personal Training – 55 and 30 minute sessions available Buddy Training – You and a friend work with a trainer (similar to 1-1training) Small Group Personal Training – anywhere between 3-10 people of similar ability working together with a trainer. Please see the reverse side of this form for pricing and packages. Equipment Orientations Available at MAC and HEM – FREE for MEMBERS Want to utilize the fitness equipment at the MAC and/or Hemenway, but don’t want to look lost? Learn your way around the spaces and how to use the basic machines safely and properly. In this 45-minute, small group session, a certified personal trainer will show you how to use the strength machines in the strength circuit, as well as the cardio equipment. Members will receive a list of the weight machines in the strength circuit along with tips on technique, moderation, progression and machine adjustments. A basic cardio training program will also be provided. Fitness Assessments Available at MAC and HEM – FREE for MEMBERS How fit are you? In what areas do you need work? How do you go about improving? In this assessment, we’ll assess your weight, body composition, Body Mass Index (BMI), cardio respiratory fitness, upper body strength, core endurance and flexibility. You’ll see how you compare to national averages, and the certified personal trainer will make recommendations for the areas in which you could improve. Personal Training Packages 55-Minute Personal Training Services 55-minutes is an optimal session length that provides an opportunity for you and your trainer to create a personalized program to meet all your health and fitness needs. Gain consistency with your exercise plan and make it your own whether you are rehabbing an injury, training for a race, or simply looking to attain overall quality health. Number of Sessions Single 3* 5 10 Individual Buddy $66 $169 $300 $575 $102 $250 $450 $852 Small Group 3-6 People N/A N/A $93 per person N/A Small Group 7-8 People N/A N/A $86 per person N/A Small Group 9-10 People N/A N/A $80 per person N/A *A 3-session package is a special, one-time offer for first time clients only. 30-Minute Personal Training Services 30-minute sessions are a great option for an experienced exerciser who is crunched for time. This individual ideally has a solid working knowledge of the weight room and proper exercise technique and is looking for extra motivation from a trainer! 30-minute sessions are also a great option for an individual who is physically or medically restricted from exercising for long periods of time . Number of Sessions 5 10 Individual Buddy $173 $335 $262 $494 Small Group 3-6 People $54 per person N/A Small Group 7-8 People $50 per person N/A Small Group 9-10 People $47 per person N/A The Fitness Manager will select your trainer and contact you to schedule the service(s) of your choice. For Hemenway Requests please contact Fitness Manager, Alex Carras At hemtrain@fas.harvard.edu or 617-495-3435 For MAC Requests please contact Fitness Manager, Kim Postler at kpostler@fas.harvard.edu or 617-496-8553