Youth Intake - The SHOP

Help Us Get to Know You

This form allows us to get to know you, understand your goals and your athletic, training, and injury history in order to coach you as effectively as possible.

"*" indicates required fields

PARENT/GUARDIAN INFORMATION

Parent/Guardian Name*

First Last

Parent/Guardian Phone*

Parent/Guardian Email*

Parent/Guardian Address*

Street Address City State / Province / Region ZIP / Postal Code

How Did You Hear About Us?*

ATHLETE INFORMATION

Athlete Name*

First Last

Athlete Phone

Athlete Email

School*

Date of Birth*

TRAINING GOALS

Short-Term Fitness Goals (Next 30 Days)*

What do you want to accomplish in the next 30 days?

Long-Term Fitness Goals (Next 12 Months)*

What do you want to accomplish in the next 12 months?

Commitment to Your Fitness Goals*

On a scale of 1-10, how committed are you to hitting your goals?

TRAINING HISTORY

Training Experience*

What is your experience with functional training, including barbells, kettlebells, and bodyweight training?

ATHLETIC HISTORY

Current Sports and Other Physical Activities*

What sports or other physical activities are you currently participating in?

Other Sports and Physical Activities*

What sports or other physical activities have you participated in? At what age and level?

INJURY HISTORY

Current Injury and/or Pain*

Are you currently experiencing pain due to injury or other medical conditions? If yes, please elaborate as much as possible.

Previous Injury and/or Pain*

Have you experienced any major injuries in the past? Do they still impact you in any way? If yes, please elaborate as much as possible.

Movement Restrictions or Limitations*

Are there any limitations to your movement or otherwise that we should be aware of? If yes, please elaborate as much as possible.

Media Consent*

Do we have parental consent to post pictures and videos of the athlete on social media platforms?

Yes

Phone

This field is for validation purposes and should be left unchanged.

Youth Athlete Intake Form