COACHING SIGN UP **NOTE – If you are a returning TMT Athlete, please fill out the returning athlete form. Name*Address* Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanÅland IslandsAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarrussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCôte d'IvoireCroatiaCubaCuraçaoCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRéunionRomaniaRussiaRwandaSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUS Minor Outlying IslandsUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabwe Country Phone Numbers*specify type cell, home, work etcBest time to reach youEmail* Enter Email Confirm Email Gender*MaleFemaleDate of Birth (mm/dd/yyyy)* Date Format: MM slash DD slash YYYY Preferred Contact Method*PhoneEmailEitherWhich sport are you seeking coaching for*Date to start training program* Date Format: MM slash DD slash YYYY How did you find out about Transition Myself Training*Your Health HistoryHeightWeightDo you have, or has anyone in your family ever had coronary artery disease*YesNoPlease explain*Do you ever experience chest, shoulder, neck, or arm pains after exercise*YesNoPlease explain*Have you ever fainted, felt dizzy, or unusually winded after exercise*YesNoPlease explain*Has a doctor said that your blood pressure is too high or uncontrolled*YesNoPlease explain*Has a doctor ever said you have heart trouble, a heart murmur, or that you have had a heart attack*YesNoPlease explain*Are you diabetic, have a thyroid condition, or any chronic condition*YesNoPlease explain*Are you using any medications*YesNoPlease explain*Is your cholesterol level high*YesNoPlease explain*Have you ever had a complete physical exam including stress test on a treadmill or ergometer*YesNoPlease explain*Do you have any condition that a doctor says may limit your exercise*YesNoPlease explain*Have you ever smoked*YesNoPlease explain*Have you ever had a joint or back disorder or any current injury*YesNoPlease explain*Have you had surgery in last 12 months*YesNoPlease explain*Are you now, or have you been pregnant in last three months*YesNoPlease explain*Athletic HistoryList your favorite sports and years of participationDo you currently have a strength training routine, if yes please describeRate your familiarity with strength training routinesI lift weights for breakfast (excellent)I sometimes lift weights (average)I've been meaning to get to that....(little)Have you ever had an exercise related injury which caused you to stop exercising for a week or moreYesNoPlease explain*List your best races and times associated with each (relevant sports only please)*Current Athletic InformationList your goal races with date and priority level*A - goal race (1-2 at most) B - meaningful race C - training raceList your 3 most important goals*At the completion of our season, how will we know if we were successful*What is the single most important thing we must accomplish*What is your current training week like nowMonday workout*Tuesday workout*Wednesday workout*Thursday workout*Friday workout*Saturday workout*Sunday workout*Is this volume*LowNormalHighHow many hours would you consider to be a BIG WEEK*What is your longest workout in the last 3 weeks*How many weekly hours do you have available to train*Please enter a number from 0 to 40.How many hours do you sleep per night on average*Please enter a number from 0 to 24.Where do you plan to swim*Which days do you prefer to swim (select at least 3)* Monday Tuesday Wednesday Thursday Friday Saturday Sunday If pool swim, what sizeDo you swim with a group regularly*YesNoWhich group*What is the most difficult part of swimming for you*What is a long swim for you*Have you ever swum with pace zones/times*How many times per week do you bike*What do you consider to be a long ride*List your FTP, along with date calculatedDo you belong to any running groups*YesNoWhich group*How often do you change your running shoes (# months)*How many times per week do you run*What do you consider to be a long run*Preferred day off from training*MondayTuesdayWednesdayThursdayFridaySaturdaySundayList the type of equipment you ownBikeBike TrainerPower MeterGPS deviceHeart Rate MonitorSwim paddles / finsRun ShoesWetsuitHave you ever done a maximal effort fitness test to determine your heart rate zones*YesNoIn which sport(s) and on what date (most recent)*Additional questions or commentsRelease Form In consideration of being coached in an endurance sport program by Transition Myself Training, I do hereby waive, release, and forever discharge Transition Myself Training, and all employees and associates of Transition Myself Training, including but not limited to Chris Pickering, of all responsibility or liability from injuries or damage resulting from my participation in any activities or program. I do also hereby release all of those mentioned and any others acting upon their behalf from any responsibility or liability for any injury or damage to myself, including those caused by the negligent act or omission of any of those mentioned or others acting on their behalf or in any way arising out of or connected with my participation in any activities of Transition Myself Training.* I understand and am aware that the program given to me from Transition Myself Training, including the use of equipment, involves a risk of injury, and that I am voluntarily participating in the program and using my equipment with knowledge of the dangers involved. I here by agree to expressly assume and accept any and all risk of injury. * I do hereby further declare myself to be physically sound and suffering from no medical condition, impairment, disease, infirmity, or illness that would prevent my participation in any physical exercise program. Nor am I prevented, for any reason, from the use of exercise equipment or machinery except as may be noted hereinafter. * I do hereby acknowledge that I have consulted with my physician regarding my intention to participate in a Transition Myself Training program. The only restrictions I have respecting my ability to participate in this program are as followsToday's Date* MM DD YYYY Full Name (Digital Signature)*Signature* Δ