ONLINE TRAINING PROGRAM PARQ

Please fill out this form as accurately as possible, this will allow better understanding for our coaches so programs can be specified accordingly, if you can't answer your 1RM please guesstimate where your 1RM would be.

Please complete the form below

Name

First Name

Last Name

Email Address

Mobile Number

Date of Birth

MM/DD/YY

Height

Weight

Occupation

Injuries/Hospitlization

Within the past 2 years

If selected YES please describe in detail?

Sport:

Position:

If applicable

Describe your overall Training History?

Briefly describe your training over the last 4-6 weeks

Do you have any past medical history that may restrict you from this program?

If YES please explain in detail?

Are you currently suffering from any injuries that may limit your training? If yes, please explain:

Describe in detail your training goals?

List 2-3

What Facility do you train in?

e.g Performance Gym, Commercial Gym, Home/Work Gym

Squat 1RM

1 Rep Max = Heaviest Load you can lift for 1 Rep or Guesstimate

Bench 1RM

1 Rep Max = Heaviest Load you can lift for 1 Rep or Guesstimate

Deadlift 1RM

1 Rep Max = Heaviest Load you can lift for 1 Rep or Guesstimate

Power Clean 1RM

1 Rep Max = Heaviest Load you can lift for 1 Rep or Guesstimate

Max (reps) Pull ups

Anything else you want us know?