Smart Athlete Client Intake Form
Check out www.smartathlete.ca for details on coaching and training plans

Questions or having trouble? Email peterglassford@gmail.com

Collecting Data to help build your training better and ensure nothing has changed

Not required for Bike Skill Sessions

* leave things blank if not applicable*

Email address *
First and Last Name *
Your answer
Mailing Address with city/region/country *
Your answer
Birthdate *
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Height *
Your answer
Weight and Waist/Hip Measure (use soft tape)
Your answer
Phone Number *
Your answer
I do not have a Heart Condition, or other conditions that would limit my ability to exercise. *
I answered NO to all Par-Q Questions ? *
Captionless Image
Required
How Did You Hear About Smart Athlete?
Give referring friends a shout-out , youtube? google? Facebook? at the races ? training peaks? magazine?
Your answer
Which service are you considering? OR How Can I help?
Your answer
Is there a date you would like to start working together?
MM
/
DD
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