HURTBOX Sign Up Questionnaire
We'll try to keep this as pain free as possible! All information provided is confidential
First Name *
Your answer
Last Name *
Your answer
Date of Birth *
We won't tell anyone....promise!
MM
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Gender *
Mobile Number *
Your answer
e-mail Address *
Your answer
Weight in kg *
Again, don't worry. It's our little secret!
Your answer
Your Cycling Experience *
Tell us about your big event(s) or goals for the year... *
This could be your cycling trip abroad in the Alps, that hilly sportive you want to complete, an upcoming triathlon, or simply that you just to want to get fitter and lose some weight.
Your answer
What do you want to get out of your visits to the HURTBOX? *
Give us your three top things (or more!) that you want to achieve through training with us!
Your answer
Do you have any current medical conditions that we need to be made aware of? *
Your answer
Please can you provide us with a name and contact number for your 'In Case of Emergency' contact *
Your answer
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