Virtual In-Home Training, Inc.

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Welcome to VIT, Inc.

To get started, complete, and submit the online form below.
Please fill each field as accurately as possible.

A VIT, Inc. rep will contact you on the day and at the time you specify.

Release of Liability

Prior to your first session and after you speak with your VIT, Inc. rep, we'll need you to please print, sign, and fax or mail our release of liability form.

Download required Release of Liability form. (Adobe PDF Format)

Requires Adobe Acrobat Reader

Fax signed form to: 1-813-375-8013

Mail signed form to:

VIT, Inc.
(c/o Margaret Stead)
2901 Landmark Way
Palm Harbor, FL 34684.

Personal Fitness Questionnaire

All fields with an "*" are required.

Our Privacy Policy

* Name:
Date Of Birth:	(xx/xx/xxxx)
Street Address:
Address (cont.):
City:
State/Province:
Country:
Zip/Postal Code:
* Phone + area code:
* Email address:

* What are your fitness/wellness goals? Please be specific.
(i.e. lose 10 lbs, firm up, strengthen upper body, etc.)

Do you have any physical limitations? Yes No
If Yes, please explain.

Have you ever hired a personal coach/trainer in the past? Yes No

Why have you decided to seek the assistance
of a personal fitness coach/trainer now?

Why have you decided to train virtually?

What type of exercise equipment do you current have?
(i.e., 5 and 8 lb hand weights, exercise ball, jump rope, Stairmaster, etc.)
Please list all that apply.

Do you own or have access to a computer? Yes No
PC Mac Desktop Laptop

Do you own or have access to a webcam? Yes No
If Yes, what type?

Do you have or use any chat programs?
(i.e., Windows Live Messenger, AOL Instant Messenger, Yahoo, etc.)
List all that you have or use.

Which days/times of the week are you available to meet
with your coach/trainer? Include all that apply.
(i.e. Mondays and Wednesdays 10-12 a.m. and 5-8 p.m.;
Tuesdays and Thursdays 1-5 p.m., etc.)

How would you like us to contact you? By Email By Phone

If by phone, what would be the best day to call?

If by phone, when would be the best time to call?
Morning Afternoon Evening Anytime
Or, set a specific time/date: (i.e., 2:45pm on x/x/2008)

Any additional comments or questions?

Regarding Our Privacy Policy:
Virtual In-Home Training, Inc. respects your right to privacy.
Any and all information submitted is for our internal use only
and will not be released to any outside entity.