Name

First Name

Last Name

Email Address

Phone

(###)

###

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How long can you train each day, and which day(s) do you prefer to have off?

What's your longest run, ride, swim in the last 2 months. Please describe and state how long it/they took.

TRIATHLETES ONLY: describe a typical swim workout and weekly distance.

How many hours do you train on a weekly basis?

What day do you like to do your long weekly workout?

List current races on your schedule and goals you have for them.

Any other info I should know that would help me get you to your goals?