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!
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Gender
Mobile Number
Your answer
e-mail Address
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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!
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Do you have any current medical conditions that we need to be made aware of?
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Please can you provide us with a name and contact number for your 'In Case of Emergency' contact
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