Athlete Information Questionnaire
"Any good training plan takes into account the life of the athlete for which it's intended."
Please complete the following questionnaire so that we can properly prepare your program.
Please feel free to email our coaches if you have any questions at Info@TRImyCoach.com
1. Personal Information (* required information)
First: *
Last: *
Address: *
City * State * Zip *
Phone: Home( ) - ; Work ( ) -
E-mail: *
Date of Birth: / / (MM/DD/YYYY)
Height: Weight:
Sex: Male Female
2. Background Information
Athletic Background - List any sports, how long were you involved, and at what level (e.g., recreational, high school, college, national, international, etc.)
Have you had any prolonged sickness or nagging injury in the past 6 months?
Please list any current medical conditions (high blood pressure, asthma, pregnancy, diabetes, etc)
Are you currently taking any medications?
3. Training Information
What are your #1 and #2 goals/events for the season?
If you are purchasing a SmartTrainer program you can skip to section 5 to complete your questionnaire. If you are choosing the customized MyPersonal training path then continue with this section.
What race(s) are you targeting this year?  Please include race names and dates and which races will be priority races for you.  *Required to complete your program*
What is the busiest day(s) of the week for you?
Are there any dates that you will not be able to train this quarter (ie vacation, business trips, etc)?  If traveling, list equipment that you will have available. (eg run and swim only - no bike)
What is the number of hours that you can allot to train weekly?
4 - 6 hours
6 - 10 hours
9 - 13 hours
11 - 15 hours
15+ hours
Other:

Do you have access to a health club, gym, or YMCA?
Yes No

Rank your nutritional habits on a scale of 1 - 5.
Do you have a heart-rate monitor and training logbook?
Yes No
What days are best for you to swim?
In the last two weeks, what was your longest?
Swim: Yards
Bike: Hours
Run: Min
What are your personal best for?: (within the last 90 days)
5K 10K 1/2 Marathon
40K bike time trial 1500m Swim
Do you have a race specific limiting factor that you would like this program to address? (example: Improve my run technique, Leg strength on the bike, Improve swim technique, run endurance, etc)
Quickly fill in your current or ideal weekly workout sequencing: (of course, this is subject to change, but it allows the coaches to see what type of training schedule you sequenced knowing your schedule)
4. Coach Selection
Selecting your coach is a very important step in your training plan. We can select a coach for you based on geographic location, background of the athlete and coach, goals for the season, etc or you can list a coaching preference from our selection of qualified coaches below. (note - final coaching selection will be determined based on availability but we will make every effort to use the coach you select.)

Have TRImyCoach select my coach

OR

Enter the name of your coach below
5. Program Selection and Payment Information
How did you hear about us?
Referral from one of our team members, if so who?
Attended one of our clinics
Link from another site
Race Flyer, Which Race?
Other, please list

Select the Training Program that you are interested in starting:


*If you are selecting MyPersonal - Option 2 - Pick my number of weeks

 Enter number of weeks desired:   

(if you're not sure how many weeks you need to get prepared then enter "not sure" and your coach will contact you to discuss your plan)

Form of Payment: Credit Card Check Gift Certificate
Certificate Number:
For check send payment to:

TRImyCoach.com
101 Scots Fir Lane
Cary, NC 27511
(919) 362-5562

(please make check payable to TRImyCoach.com)
For Credit Cards

Type of Card
Name on Card
Card Number no spaces (ex.4213111123457890)
Expiration Date (mm/yyyy) /
CC Verification Number What is Credit Card Verification Number?

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