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
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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
Which 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?
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If yes, what might those limitations include?
Have you ever sustained any major injuries?
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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?
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(Arthritis, Bursitis, Tendinitis, shoulder, knee, hip, or lower back pain, etc?)
How many total years of strength training experience do you have?
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<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?
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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?
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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
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Specify type of gear worn (belt, knee sleeves, wrist wraps, no belt?) If not applicable, put "n/a"
If these PR's 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?
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What are your perceived weaknesses in each lift? In other words, when you miss a lift, where do you typically fail?
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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?
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Are you able to do dips? (Strict, full ROM). 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?
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What exercises do you enjoy? Which ones do you dislike? Why?
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Are there any movements you can't/won't perform?
How many days/week can you devote to training?
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List the specific days you wish to train and or days you would be unable to train due to other commitments.
(For example: if you have to squat on Monday due to equipment availability and/or spotters, training partners, etc. Or perhaps you work a 12 hour shift every Tuesday..)
What time of day do you typically train? Is that time chosen out of necessity or preference?
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How many hours can you devote to each training session?
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If training at your own facility (other than Iron Arena), please list your available equipment.
*
What are your current, specific goals?
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Please list the numbers you’re hoping for and the dates in which you’d like to achieve them.
What motivates you?
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What do you think has been holding back your progress?
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Are there any stressors in your life (work-related, family-related, sleep deprivation, or otherwise) that could potentially contribute to a lack of success or stall progress?
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Are you an internally (more quiet) or externally (louder, more psyched-up) motivated lifter? In other words, what’s your arousal level like when approaching a heavier lift?
*
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.
In addition, All individualized programs are for the use of the customers of Iron Arena and are not to be resold on the internet or used to coach other individuals. The programs are not to be posted online and are the intellectual property of the owner of Iron Arena.
