Back Welcome to World Gym AthleticsFull Name*Contact Phone*Email*1. Which is the most important key to your success? (tick all that apply) Select All Accountability Motivation Support Encouragement Diet/Nutrition Fun Planning Routine Variety Other Other*Describe your main goal for joining World Gym Athletics...Describe your main goal for joining World Gym Athletics...How soon would you like to reach this desired outcome?Is there anything that will keep you from reaching your desired goal?Which of the following outcomes of joining Athletics are most important to you? (tick all that apply) Select All Performance as an Athlete Anti-aging Improve overall health Encouragement Diet/Nutrition Lose weight/decrease body fat Gain weight/increase muscle mass Social & Recreational connection Reduce anxiety and depression Pre-post rehabilitation Improve self confidence Other Other*Do you participate in any recreational activities? (eg. Golf, skiing, triathlons…)Technique AssessmentOur coaches would like to know a bit more about your weightlifting experience. If you’ve never lifted before, tick ‘unsure’.Squats - Back or Front Athletic Very Good Good Moderately Good Poor Other Other - Please describeDeadlifts Athletic Very Good Good Moderately Good Poor Other Other - Please describeCleans - Power or Squats Athletic Very Good Good Moderately Good Poor Other Other - Please describeOverhead Work - Push Push, Strict Press Athletic Very Good Good Moderately Good Poor Other Other - Please describeHeart Rate MonitorDo you own/wear a Myzone? Yes No If you answered ‘no’ would you consider buying a Myzone. Yes - please send more information No What is your Maximum Heart Rate (MHR)This can be calculated by using the following: 211 – (0.64 x age) Training HistoryHave you trained in a gym/crossfit before?What are your preferred days to train? Monday Tuesday Wednesday Thursday Friday Saturday Sunday What time would be best to participate in classes? Early mornings eg: 5am, 6am Mid Morning - 8.30am Mid Morning - 9.00am Afternoon - 3.30pm Afternoon - 4.00pm Afternoon - 4.30pm Evening - 5.00pm Evening - 5.30pm Evening - 6.00pm Evening - 6.30pm Other Other - Please describeWorld Gym Athletic Club PerksWill you be utilising the creche’?Are you currently taking any supplements or vitamins?Are you interested in one on one Personal Training?Would you like us to send you a current World Gym Timetable? Yes No thank you Training with a buddy keeps you accountable.If you know someone who’d like to become an athlete like you, we can provide them with a FREE "5" Day/Class Trial. Provide details and we will be in contact with them.Any other feedback or comments.......THANK YOU & SEE YOU IN CLASSSignatureWorld Gym Burpengary - 3053 3170 - 159-161 Station Road, Burpengary - reception@worldgymburpengary.com.au
