Your Profile

Coaching Choice:	Jack Daniels Assigned Run SMART Coach
Name:
Email:
Phone:
Gender:	M    F
Height:
Weight:
Age:
Mailing Address:
City:
State:
Zip:

How did you find us?

1. Indicate your average weekly run total (miles or minutes) over the past 6 weeks:

miles/week  or  

minutes/week

Greatest weekly total ever:

2. Longest single run in the past 6 weeks:

miles  or  

minutes

Longest ever:

3. List distances and times of races you have run in the past 3 months:

Race Name	Distance	Time

4. Dates and lifetime bests in races you have run:

Date	Distance	Time

5. How much free time available, on a daily average, for running?

hours/day

6. How many days per week are you available for training?

1 2 3 4 5 6 7

days/week

7. What days of the week and times of day would be best for you to train?

8. Give details of any specific workouts you have performed over the past 6 weeks:

9. List races you are planning to run (or, hoping to run) in the coming 4 months:

Date	Race Name	Distance

10. Dates and distances of most important races in next 6 months or year:

Date	Race Name	Distance

11. In the field below, please provide additional information that you’d like us to know, so we can safely begin building an effective training program for you.

Eg. (Medical conditions and restrictions, past injuries, PR’s, type of schedule you can maintain, personal goals, past training info .)