Application for 495 Strength & Performance membership:
if you are under 18, STOP, and send this form to your Parent/Guardian.
Which delivery of coaching is best for you?
Please Select
What area of fitness coaching piques your interest?
Please Select
Competitor - Powerlifting
Competitor - Weightlifting
Competitor - Strongman
Power Athlete
Track & Field Athlete
Adult Training - Fitness, Health, & Weight Management
Learn - Squat, Bench or Deadlift
Learn - Snatch, Clean & Jerk
Learn - General Fitness Skill
Performance - Football Front 7
Performance - Speed & Agility
How Frequently do you currently train?
Please Select
5+ days per week
3-4 days per week
1-2 days per week
Inconsistently <1 day per week
Name (Athlete)
*
First Name
Last Name
Cell Phone
Email (Athlete)
example@example.com
Address (Athlete's primary)
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Parent Name 1
*
First Name
Last Name
Parent Cell Phone 1
*
-
Area Code
Phone Number
Parent Email 1
*
example@example.com
Parent Name 2
First Name
Last Name
Parent Cell Phone 2
-
Area Code
Phone Number
Parent Email 2
example@example.com
Athlete's Current School
*
Write out full name, e.g. North Bethesda Middle School
Athlete's Current Academic Level
*
Please Select
Elementary
6th
7th
8th
9th
10th
11th
12th
Collegiate
Athlete's Current GPA
*
Please Select
4.0 or above
3.5 - 3.99
3.0 - 3.49
2.5 - 2.99
Under 2.49
Type of Coaching Delivery
*
In-Person, Small Group only
In-Person, Private Training only
Full Coaching, Small Group and Online
Elite Coaching, Private and Online
Online Coaching Only
Drop in (less than 4 sessions per month)
Signature
Submit
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