SSPT Guided Programming Questionnaire
First Name *
Your answer
Last Name *
Your answer
E-mail *
Your answer
How did you find out about this program? *
Do you use LBS or KG (Use the metric you choose for all other answers to this form) *
This program's cycles come in 4 weeks blocks and the paypal subscription will automatically withdraw every 4 weeks. You can cancel your subscription anytime through paypal. *
How many days per week are you able/want to train, 4 is the advised number. *
How many weeks away is your next meet? (Start the count from this coming Monday)
Your answer
Squat max *
Only write one number, put in meet number if you have it
Your answer
Bench Max *
Only write one number, put in meet number if you have it
Your answer
Deadlift max *
Only write one number, put in meet number if you have it
Your answer
How many full range of motion (with strict form) pullups can you do? Do not inflate this number, it is imperative that it is accurate for the progression to work - do a test if you do not know the number. *
Your answer
Based on the maxes given and this chart (http://www.usapowerlifting.com/wp-content/uploads/2014/01/Raw-Classifications-lb.pdf) what classification are you?
Competition form of squat *
Competition form of bench *
Competition form of deadlift *
Where do you miss your squats? *
Do you have access to a Safety Squat Bar? *
Are you able to front squat? *
Where do you miss your bench? *
Where do you miss your deadlift? *
Facebook e-mail
Enter the e-mail associated with your facebook account and an invite will be sent there shortly after your application and payment are received.
Your answer
How many weeks long was your last training cycle? *
Your answer
Approximately how much weight did you increase your squat in that last training cycle? (Use the unit of measurement that you chose earlier in the questionnaire) *
You will need to pay through Paypal before completing this form. Once you have set up the Paypal subscription check bubble below (your form will be deleted if payment is not made). You can cancel the subscription anytime through Paypal and failure to pay an installment will result in termination of coaching/programming services. *
Gender *
Current Weight Class (Female Only - leave blank if Male)
Current Weight Class (Male Only - leave blank if Female)
All custom programs are for the use of the customers of SSPT and are not to be resold on the internet or used to coach other individuals. The programs are not to be posted online and are the intellectual property of the owner of SSPT. *
If no is chosen then services will not be rendered.
Assumption of Risk, Release, Waiver of Liability and Indemnification: 1. Purpose and Effect: The purpose of this release is that Client and related persons, as defined below, waive any claims against BLEST and its employees, independent contractors, or agents arising from the use of any of BLEST's services whatsoever or from mere use of BLEST's training services. The effect of this release is that Client gives up the entire right to claim that someone other than Client may be held responsible for any injury which Client incurs as the result of BLEST's training services. 2. Assumption of Risk & Release: Use of BLEST's training services naturally involves the risk of harm to Client from any potential cause due to the nature of strength and resistance training; even when the lifts are performed with good form injury is always a possibility. Because of the nature of strength training the Client voluntarily accepts this entire risk. Client agrees that BLEST will not be liable for any injury, including, without limit, personal, bodily or mental injury, any economic loss or any damage to Client resulting from the negligence of BLEST, its employees, independent contractors or agents. 3. Defense and Indemnification: If there is any claim by anyone arising from any injury, loss, or damage described above which involves Client or anyone to whom Client may have provided information regarding BLEST's training services, Client agrees to (a) defend BLEST against such claims and pay BLEST for all expenses arising from the claim and (b) indemnify BLEST for all liability to Client or anyone to whom Client may have provided information regarding BLEST's training services resulting from such claims. 4. Medical Release BLEST advises that all applicants seek out medical clearance from a Doctor before starting any BLEST program. Because of the nature of online coaching BLEST employees are not available to check and/or clear clients to start programs. By sending out a program and offering online support BLEST is not stating that the client is fit to use it, the client assumes sole responsibility for their health and preparedness and by applying for coaching is stating that they are fit to start a program. *
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Do you have any questions or concerns that you would like to mention?
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