Athlete Information

First Name (required)

Last Name (required)

Your Email (required)

Your Mobile

Your Date of Birth

Your Home Address Suburb/Town
[Suburb]

Parent/Guardian Information (if athlete is younger than 18)

First Name

Last Name

Email

Mobile

Training Information

Sport

Club Name and Team Name

What weekly physical activity/sports do you do? On what days? And how hard are they (out of 10)?

Please list the exercise equipment you have at home to work out with (include the kilograms if applicable).

To gain further insights into your sporting performance profile, it is advisable you leave your coach's contact details (NAME, PHONE). BUTLER PERFORMANCE may call them to receive individual advice that is tailored to you. This is optional.

Load Management

Have you trained with strength training equipment before? If so, explain how you have and for how long.

Have you performed running sessions before? If so, explain the typical sessions you have completed and also when you did these.

Mindset

Regarding physical performance, what are the pain points (i.e. the areas you feel you could be doing better in)?

(A) What would be your goals/indicators of success (short-term &/or long-term) for this training? (B) What commitments will you make to yourself to get there?

Select the four character traits that are your strongest?

AdventurousAgreeableAppreciativeAuthenticBraveCalmCapableCaringCheerfulCleverCompassionateConfidentConsiderateCooperativeCourageousCreativeDedicatedEasy-goingEnthusiasticExcitingFairFocusedForgivingFriendlyGenerousGentleGratefulHappyHardworkingHelpfulHonestHumbleJoyfulKindLovingNiceOptimisticOrganizedPassionatePatientPeacefulPrincipledReliableRespectfulResponsibleSelf-disciplinedSelflessStrongTrustworthyUnderstandingUnselfishWise

Select the four character traits that require the most personal development?

AdventurousAgreeableAppreciativeAuthenticBraveCalmCapableCaringCheerfulCleverCompassionateConfidentConsiderateCooperativeCourageousCreativeDedicatedEasy-goingEnthusiasticExcitingFairFocusedForgivingFriendlyGenerousGentleGratefulHappyHardworkingHelpfulHonestHumbleJoyfulKindLovingNiceOptimisticOrganizedPassionatePatientPeacefulPrincipledReliableRespectfulResponsibleSelf-disciplinedSelflessStrongTrustworthyUnderstandingUnselfishWise

Injury History

(A) What injuries (that have lasted 3+ weeks) have you had in the past 3 years? (B) What were the dates of injury? (C) How long did they last? (D) How did these injuries occur? (E) What did you do about them?

Please explain in detail any other injuries/complications or health issues that may affect your involvement in a training program (e.g. surgery, serious injuries before the past 3 years)?

Do you have a personal physiotherapist/health practitioner? If so, please leave their business & contact details (CLINIC NAME, PERSONAL NAME, PHONE). BUTLER PERFORMANCE may call them to receive individual rehabilitation advice that is tailored to you. This is optional.

Training Plan

What mode of training would you like to perform with BUTLER PERFORMANCE?
OWN IT Option - Comprehensive Annual S&C with Initial Strategic Analysis (Online)ELITE Option - Comprehensive Annual S&C with Regular Strategic Analysis and Management (Online)PROFESSIONAL OPTION - In-Person & Comprehensive Annual S&C CoachingOther

Requirements

Do you understand that if you want to achieve your goals that you will need to consistently commit to performing hard physical exercise?
YesYes, bring it onI'm not ready for this yet

Any Further Questions?

Do you have any other questions or comments? (Add in anything else you would like to ask or tell us about)