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1
Name
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First Name
Last Name
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2
Email
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example@example.com
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3
Phone Number
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Please enter a valid phone number.
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4
Instagram Handle & Name on Facebook:
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5
What are your roller derby goals?
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Make the roster, get an MVP, feel more confident on the track, be a jammer, etc
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6
Are you working on an other health/fitness goals outside of derby?
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More agility, better endurance, more strength, etc
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7
Are you a blocker, jammer, pivot, or unsure?
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8
On a scale of 1-5 how important is it for you to reach those goals? (5 being EXTREMELY important)
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9
We will be calling you for our pre-application call. Can you be at a place where you’ll be fully present and focused for 10 to 15 minutes?
YES
NO
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10
How did you find Krash Course?
Facebook
Instagram
Podcast
Someone Told me about you
E-Book Download
I got your email
Tournament
Challenge
TickTok
Youtube
Other
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11
Should you be accepted into the Krash Course program, who is responsible for making the financial decision to move forward?
I am the sole decision maker and I am financially comfortable to do this on my own
I am the sole decision maker and I might need a payment plan option
Myself and my partner make these decisions together and we are financially comfortable to move forward
Myself and my partner make these decisions together and we may need a payment plan option
I am not in a position to invest in myself, please send other option.
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