New Athlete Registration Form

KSR Performance

Burleigh Heads, QLD,4220

ksr.performance@outlook.com.au

(+61) 417 192 510
New Athlete Registration Form
Athlete Details:
Full Name*

First NameLast Name
Date of Birth

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

Postal / Zip CodeState / Province

CityCountry
Phone Number*
E-mail
example@example.com
Emergency Contact Details

First NameLast Name
Relationship
Phone Number
Please enter a valid phone number.
How did you hear about us?*
If Other Please Specify
What are your goals? Short, medium and long term.
3 Months:

6 Months

12 Months:
What are some areas you would like to improve: eg. Speed, Endurance, Skills etc.
What are your everyday life commitments outside of training that stop you from living the "Pro Life".
What is your current level of training?

Club (0-5hrs)Continental (5-10hrs)Pro Tour (10-15hrs)World Tour (15hrs +)
Describe your current fitness level and your last 6 months of training.
What is your current threshold? (if known)
What threshold test did you do? (if known)
Please list any past or present injuries that you have/had: Include dates and how they happened.
What are you training for?
Would you be interested in Nutrition help to go alongside your training plan.

YesNo
Do you have access to a home trainer or Zwift?
If yes what type?
Should be Empty: