Tom Poole Coaching - Intake Form
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Player Name: *
Player Gender: *
Player Date of Birth: (DOB) *
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DD
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Player Age: *
Player Email Address:
Parent Email Address: *
Address Line 1: *
City: *
State: *
Zip Code: *
Contact Phone Number: *
What Tom Poole Coaching packages are you interested in? *
If you want small group training, how many players are in your training group?
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If you want small group training, what are the names and contact information of the other group members?
What are your preferred training days? *
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What are your preferred training times? *
Required
What are your preferred training locations? *
What is the highest level of competition played? *
What club and/or school are you currently playing for?
What position(s) do you play? *
What are your leading attributes as a soccer player? *
What are you hoping to gain from our training sessions? *
List your top-3 soccer related goals you wish to accomplish in the next 12-months? *
How did you hear about my coaching services? *
Would you want to receive additional soccer resources? *
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