ARC Participation Form
Thank you for your interest in ARC.  We look forward to reading your application.  Your responses will be reviewed to assess your fit for the program, so the more thoughtful you are with your responses, the better! We believe in you!  ***Please note that you will be receiving email correspondence regarding your application from TeamARC@activeresoluteconnected.com
Sign in to Google to save your progress. Learn more
Email *
First Name *
Last Name *
Phone Number *
Tell us a bit about you and your journey. What struggles have you faced and overcome? Do you have a background in running? *
If selected to participate, what are your goals for the ARC program? *
What does being a runner mean to you? Do you consider yourself a "runner?" Why or why not? *
Tell us about the dreams and aspirations you have for your life. If you are able, please tie this into how you feel running will help you put these dreams into action. *
Do you currently have any health concerns or pain symptoms? *
If you have had pain over the last month, please include additional information (Where is the pain located? Are you currently taking medication for pain? Are you seeing a doctor? Do you have any restrictions?). This information is very important for our team! *
Tell us about any barriers to running that you have experienced (examples include: race, ethnicity, body type, perceived ability, age, etc.). *
In your opinion, do you have good running shoes? Why or why not (please include any information on financial barriers).
If you already run and would like to participate in ARC to take your running to the next level, please give us more information (if you are new to running, enter N/A).
How well do you cope with stress and adversity? *
Not very well
Very well
Which of the following benefits of running are most important to you? (select three that are most applicable) *
Required
What is your annual income? *
Do you have the finanical means to afford programs such as online running coaching or virtual physical therapy to help with your fitness goals? *
Required
If you do have the financial means, why have you not yet taken advantage of these types of programs before? (check all that apply). If you do not have the financial means, select N/A.
Can you currently commit at least 3 days a week to training with ARC?
Clear selection
Will ARC be your ONLY formal training program during the 8 weeks you are enrolled?
Clear selection
How long have you been running? *
Please enter your age: *
Do you have access to Health Care? *
Required
What is the highest level of education that you have completed? *
Required
Ethnicity/Race (check all that apply) *
Required
Street address
City
State
Zip code
How do you prefer we communicate with you? *
Can ARC use your demographics and data (name will be omitted) as we compile the research needed to raise funds to continue to empower future participants through the ARC program?
Clear selection
Can ARC post or repost your pictures/videos to build awarenes as week seek to empower future participants through the ARC program?
Clear selection
You may also submit a video (no longer than 1 minute) to ARC telling us more about your story and why you'd like to be a part of the progam. Please email your video to TeamARC@activeresoluteconnected.com (video is optional). Please indicate below if you intend to submit a video.
Clear selection
A copy of your responses will be emailed to the address you provided.
Submit
Clear form
Never submit passwords through Google Forms.
reCAPTCHA
PrivacyTerms
This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy
Google Forms