Apply for Remote Training (Not In-Person)

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Once you've applied, Scott will be in contact with you within 72 hours.

Email *

Is the athlete 12 or older? Age minimum for remote coaching is 12. *

Yes

Player Name & Date of Birth *

Your Name *

Players under 18 must have their parents fill out this form in order to be contacted. If you think you have an exception, please email support@healthyvelo.com. Which describes you? *

I’m a Player under 18

I’m a Player 18 or older

I’m a Parent/Guardian

I’m a Coach

If you’re under 18 and/or would not be paying for your training, are your parents filling out the form with you and would be present on the call if we take the next steps forward? *

Yes

I’m the parent/guardian

I’m over 18 and pay for my own training

Best phone number for you? *

May I text this number? I need to know this number can receive texts and that you'll repsond. *

Yes

Yes, but prefer phone calls only please.

What City, State do you live in? This is important because of the time zones with my clients across the country. *

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms