Name
*
First Name
Last Name
Phone
*
(###)
###
####
Email
*
City
*
State
*
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Gender (M/F)
*
M
F
Age
*
Under 18
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
Height
*
Short
Average
Tall
Weight
*
Prefer Not To Answer
Underweight
Healthy weight
Overweight
Obese
Current Fitness Level
*
Beginner
Average
Advanced
Elite
Average Days Per Week Running
*
0
1 - 2
2 - 3
3 - 4
4 - 5
5 - 6
7
Describe Last 12 Months Of Running
*
Average Days Per Week Cross-Training
*
0
1 - 2
2 - 3
3 - 4
4 - 5
5 - 6
7
Describe Cross-Training Done
Primary Goal
*
Mile
5K
10K
Half Marathon
Marathon
Other
Describe Primary Goal
*
Existing Health Or Mobility Issues Impeding Your Overall Training
*
Any Additional Questions You May Have
Running Watch?
*
Garmin
Non-Garmin, but accurately measures Time, Distance, and Pace
None - But willing to purchase
None
Access To Indoor Gym?
*
No
Yes
Access To 400 Meter Track?
*
No
Yes
Access To Treadmill?
*
No
Yes
Access To Indoor Lap Pool
*
No
Yes, but can't swim
Yes, and I'm a novice swimmer
Yes, and I'm an average swimmer
Yes, and I'm an advanced swimmer
