Name
*
First Name
Last Name
Gender
*
Male
Female
Age
*
Email
*
Phone
*
(###)
###
####
Address
*
Address 1
Address 2
City
State/Province
Zip/Postal Code
Country
How did you find out about Iron Arena/Who were you referred by?
*
Height
*
4'6
4'7
4'8
4'9
4'10
4'11
5'0
5'1
5'2
5'3
5'4
5'5
5'6
5'7
5'8
5'9
5'10
5'11
6'0
6'1
6'2
6'3
6'4
6'5
6'6
6'7
6'8
6'9
6'10
6'11
Bodyweight (lbs.)
*
What weight class are you competing in?
*
Do you currently have any illness or infection of any kind that might inhibit your ability to train?
*
Do you currently take any medications that might inhibit your ability to train?
*
If yes, what might those limitations include?
Have you ever sustained any major injuries?
*
If yes, please list and explain
Do you have any physical limitations that I should know about? Or that may inhibit your ability to train?
*
(Arthritis, Bursitis, Tendinitis, shoulder, knee, hip, or lower back pain, etc?)
How many total years of strength training experience do you have?
*
<1
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
20+
How many years have you been competing in powerlifting?
*
0
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
20+
How many competitions have you participated in?
*
0
1
2
3
4
5
6
7
8
9
10
11-15
15-20
20+
Please list your training & meet PR's in Squat, Bench Press, Deadlift
Specify type of gear worn (belt, knee sleeves, wrist wraps, no belt?) If not applicable, put "n/a"
If these PRs were achieved more than six months ago, please provide the dates when they were achieved
*
If not applicable, put "n/a"
Do you deadlift with a conventional or sumo stance? What is your PR with the opposite stance?
*
What are your perceived weaknesses in each lift? In other words, when you miss a lift, where do you typically fail?
*
Are you able to do pull-ups/chin-ups (strict, fully-extended dead-hang, chin-over-the-bar)? If so, how many reps to failure?
*
Please list a brief overview of your training history. What training methods have you been using lately? What’s worked? What hasn’t been productive?
*
Please read the waiver below
*
In consideration of being allowed to participate in the activities and programs offered by Iron Arena LLC., and to use its programs and training, in addition to the payment of any fee or charge, I do hereby waive, release and forever discharge and hold harmless Iron Arena LLC. from any and all responsibility, liability, cost and expenses, including injuries or damages, resulting from my participation in any activities, or my use of any programs designed by Iron Arena LLC. I do also hereby release Iron Arena LLC. from any responsibility or liability for any injury or damage to myself, or in any way arising out of or connected with my participation in any activities with Iron Arena Powerlifting & Performance or the use of any equipment of Iron Arena Powerlifting & Performance.
