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ZIA Speed Academy Training Form
Helping young athletes stand out in their sport by becoming faster, sharper and more explosive
Private and semi-private performance training (Max 6 athletes per semi-private session)
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Email
*
Your email
Athlete Full Name:
*
Your answer
Date of Birth:
*
Your answer
Age:
*
Your answer
Participant Type
*
Under 18 (Parent/Guardian details required below)
18+ (No parent details required)
Required
Primary Sport:
*
Oztag/ Rugby League/ Touch Footy
Soccer
Athletics
Other:
Required
Training Experience Level
Beginner (0-6 months) New to structured sprint or athletic training
Intermediate (6-12 months) Some training experience and plays competitive sport
Advanced (1+ years) Experienced athlete aiming to maximise performance
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Current Team / Club (if applicable):
Your answer
Parent/Guardian Full Name:
Your answer
Phone Number:
*
Your answer
Email Address:
*
Your answer
Emergency Contact Name:
*
Your answer
Emergency Contact Phone Number:
*
Your answer
Do you (does your child) have any medical conditions?
*
No
Yes (please specify)
Required
Any current injuries?
*
No
Yes (please specify)
Required
I confirm I am medically fit (or my child is medically fit) to participate in high-intensity sprint and athletic training
*
Yes
Required
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