Custom-designed Training & Nutrition Questionnaire

If you're ready to transform your physique today, print the following questionnaire, fill it out, and mail it to:

Preston Rendell

30 Freeman Road

Yarmouthport, MA 02675

Also send a check or Money Order (Please check one)

Training Program -                  $40.00_______________

Nutrition Program -                 $40.00_______________

Training & Nutrition Program - $70.00_______________

Renewal Training Program -     $25.00_______________

 

Remember, you're getting a training and nutrition program from a former Mr. USA who has been in the physical culture business for over 30 years and has trained thousands of people. You'll get the exact workout card I use in my health clubs.

*Please Print*

NAME:_________________________________________________________________________

STREET ADDRESS:_______________________________________________________________

CITY:____________________________    STATE:___________________    ZIP:____________

TELEPHONE:(______)____________________    EMAIL:________________________________

OCCUPATION:_______________________________    DATE OF BIRTH:_____/______/______

HEIGHT:___________________    WEIGHT:_________________    WRIST SIZE:____________

DO YOU WORK OUT IN HOME?:___________, OR IN A COMMERCIAL GYM?:________________

NUMBER OF MEALS PER DAY:___________    HOURS OF SLEEP PER NIGHT:______________

HOW LONG DO YOU SPEND WORKING OUT?    WEIGHTS:________    CARDIO:___________

GOALS. WHAT EXACTLY DO YOU WANT TO DO WITH YOUR PHYSIQUE (USE EXTRA PAPER IF

NECESSARY?):___________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

_______________________________________________________________________________

MEASUREMENTS (OPTIONAL):_____________________________________________________

DIET. WHAT DO YOU EAT IN A DAY AND WHAT OTHER FOODS DO YOU CONSUME IN A WEEK,

INCLUDING VITAMINS AND SUPPLEMENTS:____________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

FOOD ALLERGIES:_________________________________________________________________

AMOUNT OF YEARS, MONTHS OR WEEKS YOU'VE BEEN WORKING OUT. IF YOU'VE NEVER WORKED

OUT BEFORE, STATE THAT:_________________________________________________________

PHYSICAL LIMITATIONS OR RECENT OPERATIONS:______________________________________

_________________________________________________________________________________

_________________________________________________________________________________

CURRENT WORKOUT. SETS-REPS-POUNDS-DAYS PER WEEK:____________________________

_________________________________________________________________________________

_________________________________________________________________________________

_________________________________________________________________________________

ANY ADDITIONAL INFORMATION:_________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

__________________________________________________________________________________

 

If possible, send a picture of yourself in a bathing suit or posing suit (not necessary.)

As with any exercise routine, make sure you get permission from your physician before you start.

By submitting form, I release Preston Rendell and his related enterprises of any and all liability associated with my participation in this program.