CONTACT DETAILS
Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
-
Area Code
Phone Number
Instagram Handle
Date of Birth
*
-
Year
-
Month
Day
4 digit year, 2 digit month, 2 digit day
Gender
*
Male
Female
Other
TELL US A LITTLE BIT ABOUT YOURSELF
Why are you signing up for the Battalion Barbell group mentorship program and what would you like to achieve out of it?
*
.
Aside from training, do you have any other interests outside the sport of Powerlifting?
What are your long-term goals? Where do you see yourself in 2 years' time? (athletic, personal, professional)
*
LAST QUESTIONS
Are you happy to be shared on our social media accounts?
*
Yes
No
Any other notes/requests?
Place is only secured once payment is received.
Payment Link
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