Expression of Interest Form

1

Name:* This field is required.

First Name

Last Name

2

Phone Number:* This field is required.

0400 000 000

3

Email Address:* This field is required.

seaside_strength@outlook.com

4

Instragram Handle (optional)

@coach_madiegray

5

What services are you interested in?* This field is required.

In-person training sessions

Weekly Online Personalised Programming (higher support)

Monthly Online Personalised Programming (more independence)

6

What problem do you need help solving?* This field is required.Why are you here // What are your goals?

Build muscle

Lose body fat

Increase cardiovascular fitness

Sport-specific / performance goals (training for an event or to enhance sport)

Injury prevention / longevity / rehab

Improve lifestyle factors (nutrition, sleep, habits, recovery, stress regulation, etc..)

7

Anything else you'd like us to know? (about your current health, goals, etc...)Feel free to provide any context relating to the previous questions