Basic Information
Full Name
Phone
Email
example@example.com
Date of Birth
/
Day
/
Month
Year
DD/MM/YYYY
Questions:
1. How did you hear about us? (Old)
Friend Referral
Soical Media ( IG , FB , Youtube)
Walked by Gym
Other
1. How did you hear about us?
Friend Referral
Soical Media ( IG , FB , Youtube)
Walked by Gym
Other
2. Have you trained in Brazilian Jiu Jitsu or other martial arts before? (OLD)
No, my first time
Yes, I have some experience before
Yes , I have trained in BJJ before
2. Have you trained in Brazilian Jiu Jitsu or other martial arts before?
No, my first time
Yes, I have some experience before
Yes , I have trained in BJJ before
Months / Year
(Optional) Answer this only if you have trained BJJ before
Which Martial Arts:
(Optional) Answer this only if you have experience other martial arts before
3. What is your main reason for training BJJ? (OLD)
Self Defense
Fitness & Weight Loss
Stress Relief & Mental Health
Personal Development
Competition & Sport
Social Connections, Community
Career ( MMA , Law enforcement , coaching )
3. What is your main reason for training BJJ?
Self Defense
Fitness & Weight Loss
Stress Relief & Mental Health
Personal Development
Competition & Sport
Social Connections, Community
Career ( MMA , Law enforcement , coaching )
Other
4. What is your short term goal in next 3 months? (OLD)
Attend at least 2-3 class per week
Lose weight and improve cardio
Learn fundamental techniques (guard, submissions, etc.)
Earn my first stripe
Other
4. What is your short term goal in next 3 months?
Attend at least 2-3 class per week
Lose weight and improve cardio
Learn fundamental techniques (guard, submissions, etc.)
Earn my first stripe
Other
5. What is your long term goal in BJJ? (OLD)
Get black belt
Compete a lot
Train consistently
Become a gym owner / instructor
Other
5. What is your long term goal in BJJ?
Get black belt
Compete a lot
Train consistently
Become a gym owner / instructor
Other
6. What concerns do you have about BJJ? (OLD)
Injury
Feeling lost / confused
Training with higher belts
Time commitment
Financial cost
Other
6. What concerns do you have about BJJ?
Injury
Feeling lost / confused
Training with higher belts
Time commitment
Financial cost
Other
7. What would make it easier for you to commit to your training long term? (OLD)
A Training buddy / accountability
Flexible class times
More Guidance
Other
7. What would make it easier for you to commit to your training long term?
A Training buddy / accountability
Flexible class times
More Guidance
Other
8 What class time works for you best? (OLD)
Mornings ( 6am – 8am )
Mid day ( 11am – 2pm)
Evening ( 5pm – 9pm )
Weekends
Other
8 What class time works for you best?
Mornings ( 6am – 8am )
Mid day ( 11am – 2pm)
Evening ( 5pm – 9pm )
Weekends
Other
9. Are you interested in attending training or services? (OLD)
Strength & conditioning classes
Nutrition & weight loss coaching
Private classes
Comp Training
Mentorship
Self Defense workshop
9. Are you interested in attending training or services?
Strength & conditioning classes
Nutrition & weight loss coaching
Private classes
Comp Training
Mentorship
Self Defense workshop
10. Would you be interested in accountability challenge? (e.g.: weight loss goals, attend 10 classes a week, etc.) (OLD)
Yes, I would like that
Maybe if there was a reward
No, I like to work at my own pace
10. Would you be interested in accountability challenge? (e.g.: weight loss goals, attend 10 classes a week, etc.)
Yes, I would like that
Maybe if there was a reward
No, I like to work at my own pace
11. Would you refer your friends / family to the gym? (OLD)
Yes
No
Other
11. Would you refer your friends / family to the gym?
Yes
No
Other
12 Any other suggestions recommendations
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