Cadence Athlete Questionnaire
To save your time when you come to visit the Performance Center we've made these forms available online. Please complete all sections and submit to Cadence. This will help us help you to achieve your athletic goals. Please note that fields marked with an
*
are required.
Athlete Infomation
NAME:
*
ADDRESS LINE 1:
*
DATE OF BIRTH:
*
ADDRESS LINE 2:
COACHING PKG:
Bronze-Cyclist
Bronze-Triathlete
Silver-Cyclist
Silver-Triathlete
Gold-Cyclist
Gold-Triathlete
Platinum-Cyclist
Platinum-Triathlete
Undecided
ADDRESS LINE 3:
TELEPHONE:
*
CITY:
*
FAX:
STATE/PROVINCE:
*
EMAIL:
*
ZIP/POSTCODE:
*
HEIGHT:
COUNTRY:
*
WEIGHT:
Athlete Profile
Your STRENGTHS
1.
2.
3.
Your WEAKNESSES
1.
2.
3.
Your SHORT TERM GOALS
1.
2.
3.
Your LONG TERM GOALS
1.
2.
3.
Training Schedule
Please describe your typical training week.
Last Winter
Last Summer
HOURS/MILES
(Average week)
WEIGHTS
(None, Casual, Serious,…) How many times a week?
STRUCTURED INTERVALS
(Sprints, Hill rpts., Longer T.T. Intervals, …)
NUMBER RACES
Personal Records
Please provide details.
RUN
PR's
Season Best
PR with Date
Mile
5000m
10K
1/2 Marathon
Marathon
40K TT
SWIM
PR's
Season Best
PR with Date
1500m (Pool or Openwater)
2.4 mile
Training Availability
Please list the typical hours you will be available to train.
MON.
TUES.
WED.
THUR.
FRI.
SAT.
SUN.
Morning
Evening
Additional Information
Do you have other physical or recreational hobbies? Is your work strenuous?
Describe your history of injuries or any health related matters that may affect your ability
to train at strenuous levels. Do you have chronic injuries that your training may have to be
planned around?
Do you wear orthotics in your cycling shoes or wedges under your cleats? Describe.
Describe your favorite cycling workout.
Describe your favorite running workout.
Describe your favorite swimming workout.
Do you own a heart rate monitor?
No
Yes
What type?
Do you own a power meter?
No
Yes
What type?
Do you have short, steep hills (1-2min in riding time) where you train?
No
Yes
Do you have long hills (5+min in riding time) where you train?
No
Yes
Do you have an uninterrupted flat section of road 3 miles in length?
No
Yes
Do you swim with a group?
No
Yes
Do you own or have access to an indoor trainer?
No
Yes
What type?
Do you have access to a treadmill?
No
Yes
Do you own rollers?
No
Yes
What type?
Personal Rating
Please rate yourself on a scale of 1 to 10 in the following areas
(1 = poor - 10 = outstanding)
Choose a number
Additional comments
Endurance
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Speed
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Power
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Strength
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Motivation
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Pain Tolerance
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Committment
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Flexibility
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Core Strength
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Recovery
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Positive Attitude
0
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10
Please Tell Us...
How did you hear about CADENCE Performance Cycling Centers - Philadelphia?
SELECT:
Cadence Website
Google
Yahoo
MSN
AltaVista
Internet Search
Red Rose Races
Media Advert or Coverage
Saw Store Location
Word of Mouth
Other
OTHER:
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