Your Name (required)

Your Email (required)

Phone (required)

Age (required)

Body weight (required)

Height

Sport

Position

Please list any injuries and or any exercises that currently inhibit your training.

Please list any prescription drugs and or medical/health conditions.

Please check specific goals.
 Strength Acceleration (Quickness) Top speed Agility Balance Foot quickness Muscle growth Weight loss Fat loss Flexibility (Other)

If you checked "Other" above, please list here:

How many months or years of weight training experience do you have?

Have you ever performed maximal lifts in the following exercises if so how much did you lift?

Squat:

Bench Press:

Clean:

Deadlift

Have you ever been tested in any of the following performance measurements if so what were your scores?

10yd. sprint:

40yd sprint

60yd sprint

Pro agility or 5-10-5 shuttles

Vertical jump

Body fat percentage

Other distance or test

Please list foods that you are allergic too and or want omitted from your nutrition program.

Please list any nutritional supplements that you use and how often you use them.

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