ASC Fall Middle School Sport

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Andrews Sport Conditioning Questionnaire/Waiver

Athlete name *

Parent(s) names *

Athlete date of birth *

YYYY

Athlete and/or parent email *

Emergency contact phone number *

Do you have any medical conditions or allergies? *

Yes

Required

If you answered "yes" please describe below

Please give a brief history of any injuries sustained in the last year *

Do you have any other issues that may influence your training? (ie: back pain, lingering injuries, mobility issue)

What sport(s) do you play *

What is your strongest athletic ability (ie: strength, speed, power, agility, endurance, etc.)

What athletic ability do you feel needs most improvement (ie: strength, speed, power, agility, endurance, etc.)

What are your athletic goals? Can be broad or specific (ie: make a team, score "x" amount of goals/touchdowns, become a starter, etc.)

What are some goals you wish to complete during your training at ASC?

Have you trained before (ie: strength, speed agility training) *

Yes

Have you trained at ASC before? *

Yes

If you answered "Yes" how much experience do you have training? Please give a brief description of any past training

How many hours of sleep do you get each night? (Include weekends if more or less) include times you sleep from (ie: 11pm-7am)

On average, how well would you rate your diet for your own athletic goals (1 being needs improvement, 5 being perfect)

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List below any expectations you have for ASC or any questions or concerns

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