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Fees for Training (12KB)
Please complete our query form.
Fields with an asterisk (*) are required.
Personal Details
First Name *
Last Name *
Gender *
--- Select One ---
Male
Female
Age *
Address
Street Address *
Suburb *
City / Town *
Postcode *
Contact Details
Home Phone
Work Phone*
Mobile *
Email *
Alternate Email
Sporting History
Number of Years running
Approximate weekly kilometres
Current long run distance
Does you weekly training normally include Intervals
--- Select One ---
Yes
No
Sometimes
Hill work
--- Select One ---
Yes
No
Sometimes
Plyometrics / Circuit
--- Select One ---
Yes
No
Sometimes
What other forms of exercise
are you involved in
Swimming
Rowing
Cycling
Aerobics
Weights
Other
If Other, please specify
What are your personal best times for the following distances
(hh:mm:ss)
5KM
10KM
21KM
42KM
Have you suffered any injuries
in the last two years
--- Select One ---
Yes
No
If yes, enter brief injury details
Do you have any pre-existing medical conditions that might affect your training
--- Select One ---
Yes
No
Sporting Goals
What are your immediate or
short term goals (<12 mths)
Fun and Fitness
Complete a 5-10 Km run
Complete a half/full marathon
Better my PB in 5-10km races
Better my PB in half/full marathon
Other
If Other, please specify
What are your immediate or
long term goals (>12 mths)
Fun and Fitness
Complete a 5-10 Km run
Complete a half/full marathon
Better my PB in 5-10km races
Better my PB in half/full marathon
Other
If Other, please specify
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