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First Name:
Last Name:
Age:
Sex:
Address:
Email:
Phone:
Evaluation Questions
How did you hear about us?
How long have you been running for?
0-2 years
3-5 years
5-10 years
10+ years
Why do you run?
stay fit
enjoy it
social reasons
lose weight
medical reasons
other (please explain)
How many miles per week do you walk/run?
0-5
6-10
11-20
20-30
40+
What are your running or personal goals in regards to joining MCC? (Be specific. Use dates and times when you desire these goals to be met, and what exactly your goals are)
What other activities have you done or currently do? Please elaborate in regards to the frequency, duration, and dates/times for each activity.
Please explain any current or past medical conditions that may impede your training?
Have you used a coaching or running program before?
Yes
No
If yes, what did you like and/or dislike about the experience?
When do you wish to start you training?
Today
Next Week
Two Weeks
Next Month