VIRTUAL "FIGHTING FIT" PROGRAM BOXER PROFILE PART 2
DATE:________________________________________________________
Name: ________________________________ *Age: ___________________________
DATE OF BIRTH (D/M/Y):__________ *(Min. age requirement is 16 yrs)
Address: ___________________ City: ____________________
Postal code: ________________ Province: ________________
E-mail: _____________________ Phone: (H#) _______________ Occupation: _________________ (W#) _______________
- ARE YOU YOU A PHOENIX BOXING ROOKIE? YES NO
- IF YOU A PHOENIX BOXING VET – WHAT LEVEL? 1 2 3 4 5 6
3. Are you currently physically active? YES *NO
*Reasons for Inactivity: _______________________________________________________
(*If NO – please go to QUESTION 8, and read WAIVER very carefully
to realize/accept what you have enrolled in. PHOENIX BOXING training is tough!)
- WOMEN ONLY: Are you pregnant? *YES NO
(*If YES - Please contact PHOENIX BOXING ASAP to withdraw from your course. You will receive a full refund or credit). NO PREGNANT ROOKIES - OUR TRAINING IS TOO INTENSE FOR PREGRNANT WOMEN WHO HAVE NO PREVIOUS EXPERIENCE WITH OUR GYM & TRAINING! WE LOOK FORWARD TO TRAINING & COACHING YOU POST PARTUM.
4. What type of athletics/fitness training do you currently engage in? _______________________________________
_____________________________________________________________
5. How frequently do you engage in the above training?
# of times per day: _____________________________________________________
# of times per week: ___________________________________________________
6.How long have you been training this way?
# of weeks: _____________________________________________________________
# of months: ____________________________________________________________
# of years: _____________________________________________________________
7. How would you rate the intensity of your training?
□ light □ moderate □ vigorous
i.e.: walking i.e.: jogging i.e.: sprinting
8. Why are you interested in PHOENIX Boxing Courses?
□ Learn New Skills □ Stress Management
□ Physical Conditioning (Results!) □ Satisfaction & Enjoyment
□ Challenge & Intensity □ Cross-Training for Sport
□ Structure & Commitment □ Other (specify):_________
9. How did you find out about PB’s Virtual Fighting Fit Program?
□ PB Website □ Direct mail brochure/coupon
□ Google search □ PB banners outside gym
□ Youtube □ Word of Mouth(specify): __________________
□ Facebook share □ PB outdoor posters _____________
□ Other (specify): _______________________________________________
10. What GOALS would you like to achieve with Phoenix Boxing?
□ Muscle toning □ Increase strength
□ Wellness □ Increase cardio
□ Stress Management □ Discipline/Dedication
□ Weight Management □ Self-defense
□ Cross-Training for Sport (specify):____________________
□ Other (specify): _____________________________________
