START UP

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Home
Bikes
- Apex
- Culprit
Wheels
Clothing
- Custom Clothing
More
Store

COACHING START-UP

* Indicates required field

I will be coached by? *

Select from drop down munu

CONTACT INFORMATION:

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Are you medically cleared for rigorous training? *

YES NO

SELECT ONLY ONE

Current age and date of birth? *

Gender? *

Email *

Phone Number *

If no, provide details *

Type N/A if you selected yes

Cycling Category? *

Cat 5 Cat 4 Cat 3 Cat 2 Cat 1 NONE

NON ATHLETIC LIFE:

Occupation? *

Married/Spouse/Partner? *

Yes No It's complicated

Children? If yes provide how many & ages *

Weekly hours worked? Please provide schedule *

Do you travel for work? *

Yes, a little Yes, A LOT! NO

How did you hear of CENTRIC COACHING? *

ATHLETIC HISTORY:

Select your sport *

Do you have a gym membership? *

Yes No I have a home gym

Rate your experience with strength training *

None/Zero Basic Intermediate Advanced

What gym do you use? *

Provide complete injury history & all medical conditions *

Years of Participation? *

Do you currently strength train? *

Yes No

If yes, please describe *

If no, type no

List your achievements in your sport (all you feel apply) *

CURRENT ATHLETIC INFORMATION

List all events you are registered for or wish to include for coaching? *

What does your training week look like now? *

The above week is? *

Low for me Average for me High for me

What is the longest workout or event you have completed in the past 3 weeks? *

For Triathletes: list long bike & long run)

What is the Brand, Model & year of your bike? *

List all bikes you own. Runner type N/A if you don't own a bike

Do you have a power meter on your bike? *

List brand and what bike it is on

Do you have access to a pool? If yes, what size? *

Upon completion of our first season, how will we define if we are successful? *

What is the SINGLE most important thing we MUST accomplish? *

List your 3 most important goals? *

Total weekly hours available for training (be realistic) *

What time of day to you expect to do most of your weekday/workday training? *

Morning (before work) Evening (after work) Both morning & evening

Do you have a bike trainer or rollers? *

Yes No Only spin bike at gym

Do you own a heart rate monitor? *

Yes No

What is the highest heart rate you have observed during exercise? *

Do you participate in group training? please list if yes *

EXACTLY what did you eat yesterday?... list everything *

Submit Now!

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