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Acceleration Pre-Registration

First Name: *
Last Name: *
Date of Birth: Calendar *
Gender: Male
Female
Sport:
Athlete's Contact Details:
Email Address:
By registering on our site you agree that we may send you email related to our facilities and programs.
We will not provide your details to any other company.
Home Phone:
Mobile Phone:
Work Phone:
Address:
Suburb/City:
State:
Postcode:
Mother's Contact Details:
Mother's Name:
Mother's Mobile:
Mother's Email Address:
Father's Contact Details:
Father's Name:
Father's Mobile:
Father's Email Address:
Injury Concerns
Medical Concerns
Comments
In the next year, what are the two main competitions that you are training for?
PLEASE INCLUDE EXACT DATES - APPROXIMATE DATES ARE BETTER THAN NONE.
(E.g. Exact Dates - Basketball: Rep Selection 12th - 16th Oct & Classics 3rd – 7th Apr
E.g. Approximate Dates - Swimming: State Titles 2nd week Dec & Age Nationals 1st week Apr)
What is your ‘dream’ goal?
What is potentially possible in the long-term if you stretch all of your limits?
(E.g. To play for Australia)
What is your ‘dream’ goal for this year? (E.g. Make the State U/16 Team)
Mark 3 goals in priority order that you want to work on in your Acceleration sessions below:
1=Highest Priority, 2 = Moderate Priority, 3= Lowest Priority
Skill Priority Order Rating out of 10
0=Worst 10=Best
What will you do to ensure you reach your target rating?
(practice 2/week)
Present
today
Target
Competition Date
Acceleration
Speed
First Step Quickness
Vertical Jump
Flexibility
Upper Body Strength
Lower Body Strength
Upper Body Power
Lower Body Power
Core Strength
Other
Other
List 1 sport skill that you will be working on concurrently with your Acceleration training:
Sport Skill
(e.g. increased stroke rate,
stronger rebounds,
better kicking game,
better angled drives)
Rating out of 10
0=Worst 10=Best
What will you do to ensure you reach your target rating?
(practice 2/week)
Present
today
Target
First Competition Date
Note: If you change or cancel your testing session on the day of your booking, you will lose your $30 deposit. You will have to pay another $30 deposit for your new booking.
 

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