Program Application - Barbell Built - Ben — THE FACILITY

Home Services Success Stories Team Contact

Home Services Success Stories Team Contact

First Name *

Last Name *

Email *

Cell Phone

Age *

Please list your current 5 Rep Max on the Barbell Squat / Bench Press / Conventional Deadlift (Please specify LBS or KG) *

What program specific equipment do you have access to? (Check all that apply) *

Barbell & Plates

Dumbbells

Squat Rack

Flat Bench

Adjustable Bench

Cable Row Machine

Cable Pulldown Machine

Resistance Bands (Varying Tensions)

Pull Up Bar

Dip Bars

Are you interested in an 8 week or 16 week strength training block? *

16 Week

8 Week

The program requires that you, the trainee, be able to train 4-5 X / Weekly throughout the entire program. Are you able to commit to this many training days per week? *

YES

NO

Are you able to commit to engaging 2-3 x / week in a private accountability group for trainees on a similar workout regimen? *

YES

NO

Are you able to commit to a one time payment for this program? (8 Week = $110 / 16 Week =$175) (NEW YEAR SPECIAL - ALL SERVICES 10% OFF) *

YES

NO

Would you be interested in us managing all of the specific weights you should be lifting throughout the duration of the entire program? *

Where do you live? *

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