Student Intro Form
This form helps the Mile High Artistic Skating Club coaching staff get to know you. It also helps us plan better group classes, private lessons, and helps us assist you in achieving your individual skating goals by giving us insight into how you learn and process information. Thank you for taking the time to fill it out.
Full Name
*
First Name
Last Name
DOB
*
-
Month
-
Day
Year
Date
Occupation
*
Phone Number
*
E-mail
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
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Personality Information
Understanding your personality type helps us better serve you.
I look for opportunities to serve and help others.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I embrace risk.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I believe that it is important that rules are enforced.
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1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I highly value competence.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I value predictability in my life.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I make decisions based on good analysis and good data.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I tend to be compassionate and tender to most people.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I need to be the leader.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I find joy in charitable giving.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I prefer having a step-by-step system to follow.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I place great value on expertise.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I like to be the center of attention.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I crave stimulation and excitement.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I highly value intelligence.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I am passionate about supporting the cause that I believe in.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I am disciplined and like to follow protocols, guidelines and timelines.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I crave a lifestyle of fame and fortune.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I value science and the scientific method.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
I value stability over change.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
It is important for me to make deep connections with other people.
*
1 - Strongly disagree
2 - Disagree
3 - Indifferent
4 - Agree
5 - Strongly Agree
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Personal Benefits of Skating
Understanding your goals and the benefits you value helps us better serve you.
Benefits of roller skating
*
Confidence
Social environment
Energy booster
Hobby
Health benefits
Stress relief
Relaxation
Make a special person happy
Stay Active
Competition
Exercise
Special event
Fun/Entertainment
Learn something new
Sense of accomplishment
Family time
Meet new people
Get out of the house
Time for yourself
Challenge yourself
Substitution for trouble
Be good at something
Improve balance
Improve coordination
Physical outlet
Creative outlet
Performance opportunities
Sport outlet
If you are filling this out for your child, what additional benefits or skills would you like them to learn through their involvement in the skating club?
*
Filling out for yourself
Physical coordination
Physical outlet
Physical development
Social skills
Friendships
Respect
Discipline
Focus
Determination
Time management
Cross training
Fun outlet
Family time
What styles of roller skating are you interested in?
*
Social skating
Competitive skating
Dance skating
Figures
Freestyle
S.T.Y.L.E. skating
Inline skating
Jam
Rhythm
Partner skating
Group skating
Basic skills
Are you interested in private lessons?
*
Please select a response
Yes
No
Unsure
Are you interested in competing or performing?
*
Please select a response
Definitely
Maybe
No
Unsure
I need more information
What are your skating goals?
*
What made you decide to join our club or improve your skating skills at this time?
*
What is your skating background?
*
How would you describe your learning style?
*
Submit
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