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Maui to Molokai Race Camp April 2012
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The information supplied will be kept strictly confidential and will be only used to assist your coach to better custom design your personal training program.
General Information
Today's Date (dd-mm-yyyy)
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Name
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First
Last
Address
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Line 1
Line 2
City
State
Zip Code
Country
Home Phone Number
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-
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Work Phone Number
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Cell Phone Number
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Email
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Date of Birth (dd-mm-yyyy)
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Age
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Sex
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female
male
Weight (lbs)
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Height (ft/inches)
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Unisex Shirt Size (xs, s, m, l, xl, xxl)
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Occupation
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Medical Information
Are you in good enough health to undertake this training program?
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Yes
No
If the answer to the previous question is "No", would you be able to get a doctor's note of medical clearance?
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Yes
No
N/A
Please list any medical conditions or injuries (previous and current) that we should be aware of:
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When did you last have a full medical checkup?
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Athletic Background
What is your athletic background, high school/college/post-college?
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What racing or training have you been doing in the last 3 years?
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Paddling Background
How long have you been involved in paddling?
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What craft do you most often paddle? (OC1, OC6, Surfski, Kayak, etc.)
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Strengths and Weaknesses
Describe your athletic strengths (i.e. Speed, endurance, training consistency, motivation, etc.
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Describe any athletic weaknesses (i.e. Speed, endurance, injury prone, etc.)
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What areas of paddling do you want to work on the most?
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What areas of paddling do you NOT want to work on? (if any!)
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Your Equipment/Facilities
Do you have access to a personal paddling craft?
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yes
no
Do you have access to a club paddling facility?
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yes
no
Do you have access to a heart rate monitor?
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yes
no
Do you have access to a gym/weightlifting facility?
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yes
no
Current Training Volumes
Please describe your current weekly workout schedule (number, type and duration of workouts)
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Goal Setting
Please list your TOP PRIORITY races you would like to do next season (NO MORE THAN 2)
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Please include race name, distance, date of race, and any goals for that race.
Please list your SECOND PRIORITY races you would like to do next season (NO MORE THAN 3)
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Please include race name, distance, date of race, and any goals for that race.
Submit