Name *

First Name

Last Name

Training Location(s) *

Where will you be training?

Home Gym

Commercial/Rec Center gym

Neighborhood Clubhouse

Hotel Gym

Outside

Home Fitness Equipment? *

What home fitness equipment do you have?

Dumbbells

Kettlebells

Barbells

Resistance Bands

Cable Machine (functional trainer)

Medicine Balls

Bench

None of the above

Goals *

Why do you want to start strength training?

Get Faster

Ride Longer

Improve Climbing

Avoid/Reduce Injuries

Improve Overall Health

Strength Concerns *

What area(s) need the most improvement?

Upper Body

Core

Lower Body

Core Stability - Bird Dog *

Can you complete 10 bird dogs per side and maintain your balance?

Yes

No

Core Strength - Front Plank *

How long can you hold a front plank position?

<15 secs

15-30 secs

>30 secs

Core Strength - Side Plank *

How long can you hold a side plank position?

<15 Seconds

15-30 Seconds

>30 Seconds

Shoulder Mobility - Floor Slides *

Can you complete 10 Floor Slides, touching the floor with the back of your hands, and pain free?

Yes

No

Upper Body Strength - Push Ups *

How many push ups can you complete in a planked position?

0

1-5

5-10

10+

Single Leg Balance *

How long can you balance on 1 foot?

<5 secs

5-15 secs

15-30 secs

>30 secs

Lower Body Strength - Squats *

How many body weight squats can you complete?

<5

5-10

>10

Lower Body Strength - Split Squats *

How many split squats can you complete per leg?

<5

5-10

>10

Endurance Training *

How much time per week are you completing endurance (cardio) training?

None

30-60 minutes

1-2 hours

2+ hours

Training Preference *

What type of fitness training are you interested in?

Online Training

1-1 Training

Not sure yet