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coach@gbrunning.com
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Gary
2018-04-08T15:17:03+00:00
Hello and thank you for your interest in my coaching services. If you are ready to learn more about how I may help your running, please fill out the form below. There are four sections but they each contain valuable information to help me better understand your needs and expectations. Once submitted, I will contact you via email shortly thereafter and suggest some ways we might begin. Please be as thorough as possible. Thank you, in advance!
About You
Name
*
First
Last
Sex
*
Female
Male
Address
*
Street Address
Address Line 2
City
State / Province / Region
ZIP / Postal Code
Afghanistan
Albania
Algeria
American Samoa
Andorra
Angola
Antigua and Barbuda
Argentina
Armenia
Australia
Austria
Azerbaijan
Bahamas
Bahrain
Bangladesh
Barbados
Belarus
Belgium
Belize
Benin
Bermuda
Bhutan
Bolivia
Bosnia and Herzegovina
Botswana
Brazil
Brunei
Bulgaria
Burkina Faso
Burundi
Cambodia
Cameroon
Canada
Cape Verde
Cayman Islands
Central African Republic
Chad
Chile
China
Colombia
Comoros
Congo, Democratic Republic of the
Congo, Republic of the
Costa Rica
Côte d'Ivoire
Croatia
Cuba
Curaçao
Cyprus
Czech Republic
Denmark
Djibouti
Dominica
Dominican Republic
East Timor
Ecuador
Egypt
El Salvador
Equatorial Guinea
Eritrea
Estonia
Ethiopia
Faroe Islands
Fiji
Finland
France
French Polynesia
Gabon
Gambia
Georgia
Germany
Ghana
Greece
Greenland
Grenada
Guam
Guatemala
Guinea
Guinea-Bissau
Guyana
Haiti
Honduras
Hong Kong
Hungary
Iceland
India
Indonesia
Iran
Iraq
Ireland
Israel
Italy
Jamaica
Japan
Jordan
Kazakhstan
Kenya
Kiribati
North Korea
South Korea
Kosovo
Kuwait
Kyrgyzstan
Laos
Latvia
Lebanon
Lesotho
Liberia
Libya
Liechtenstein
Lithuania
Luxembourg
Macedonia
Madagascar
Malawi
Malaysia
Maldives
Mali
Malta
Marshall Islands
Mauritania
Mauritius
Mexico
Micronesia
Moldova
Monaco
Mongolia
Montenegro
Morocco
Mozambique
Myanmar
Namibia
Nauru
Nepal
Netherlands
New Zealand
Nicaragua
Niger
Nigeria
Northern Mariana Islands
Norway
Oman
Pakistan
Palau
Palestine, State of
Panama
Papua New Guinea
Paraguay
Peru
Philippines
Poland
Portugal
Puerto Rico
Qatar
Romania
Russia
Rwanda
Saint Kitts and Nevis
Saint Lucia
Saint Vincent and the Grenadines
Saint Martin
Samoa
San Marino
Sao Tome and Principe
Saudi Arabia
Senegal
Serbia
Seychelles
Sierra Leone
Singapore
Sint Maarten
Slovakia
Slovenia
Solomon Islands
Somalia
South Africa
Spain
Sri Lanka
Sudan
Sudan, South
Suriname
Swaziland
Sweden
Switzerland
Syria
Taiwan
Tajikistan
Tanzania
Thailand
Togo
Tonga
Trinidad and Tobago
Tunisia
Turkey
Turkmenistan
Tuvalu
Uganda
Ukraine
United Arab Emirates
United Kingdom
United States
Uruguay
Uzbekistan
Vanuatu
Vatican City
Venezuela
Vietnam
Virgin Islands, British
Virgin Islands, U.S.
Yemen
Zambia
Zimbabwe
Country
Email
*
Phone
(not required)
Age
*
Weight (lbs)
*
Height (inches)
*
Current Fitness
In order to know where we should start I will need to know what, if any, running you're doing now.
On average, how many miles per week are you currently running?
*
please select
0-5
5-10
10-20
20-30
30-40
40-50
50-70
70+
On average, how many days per week are you currently running?
*
please select
One
Two
Three
Four
Five
Six
Seven
I would describe myself as...
A beginner runner.
A fitness runner with some experience.
A competitive runner.
A very competitive, local elite runner.
What is your injury history (running related or otherwise)?
*
I am injury-free and always have been.
I have had a minor injury in the past but I am injury-free now.
I have a recurring injury that I must address.
I am currently injured but am committed to running healthy.
Please provide whatever details you care to share about your injury (past or present).
Please provide details about any health concerns you may have - if any.
Personal best #1
Please include distance, time & date. (example: Chicago Marathon, 3:25:10, mm/yyyy)
Personal best #2
Please include distance, time & date. (example: Hamptons Half Marathon, 1:50:10, mm/yyyy)
Most recent race result. If you don't have a current race result, no sweat!
Please include distance, time & date. (example: 10k, 45:10, mm/dd/yy)
What has been your longest single run in the past six weeks?
*
Please include distance and/or time & date. (example: 10 miles, 1:30:00, mm/dd/yy)
Give details of any specific (running) workouts you have performed over the past six weeks.
Goals
Since you are interested in hiring a running coach you surely have some goals in mind. Goals are particularly important because they help set a direction in which to focus your efforts and specificity of training. Tell me what you hope to achieve.
How many miles per WEEK do you expect to run in your PEAK weeks of training?
*
please select
10-20
20-30
30-40
40-50
50-60
60-70
>70
On average, how many days per week do you expect to run during your training?
*
3 or less
3-4
4-5
5-6
6-7
I'm open to running double sessions on certain days.
Upcoming races currently on your calendar. List as few/many as you wish. If you have not yet registered for a race - that's ok too!
EXAMPLE: 2017 NYC Marathon, 2018 London Marathon
My long-term training goals are...
EXAMPLE 1: I would like to complete a 1/2 Marathon under 2 hours and run the NYC Marathon next fall in honor of my mother who is a cancer survivor. EXAMPLE 2: I am registered for a NYRR 10k in October and I would like to run a personal best.
My health goals are...
EXAMPLE: I am currently about 20lbs overweight and I would like to use running as a way to help shed the extra pounds.
My mental goals are...
EXAMPLE: If I don't see results quickly I typically become discouraged and give up. I would like to build up the courage to stick with a training plan.
Challenges
Equally as important to defining your goals is recognizing and ackowledging the challenges you may face along the way. Tell me a little about the challenges you foresee which may hinder your progress.
The challenges in achieving my goals are...
EXAMPLE: I'm limited on time because I work 50+ hours each week and have 3 kids.
Why I want a running coach
Your success, in whatever your goals are, is my priority. To help me fully understand what you would like get out of having a coach, please tell me what would make our partnership successful to you.
I am interested in...
*
Select ALL that apply.
Private Coaching - Bronze
Private Coaching - Silver
Private Coaching - Gold
Assessment
Pacing
Other (please describe below)
Other
Please elaborate on the service in which you would be interested - if not listed above.
I want a coach because...
*
EXAMPLES: I have been unable to maintain a steady training program on my own. I lack the motivation to run on my own so I need someone to motivate me. I need a coach for accountability. I just don't know how to train effectively.
Other details you care to share?
Anything else you would like to tell me but may have been excluded from the fields above? Write it here!
Who (or what) inspires you?
Name
This field is for validation purposes and should be left unchanged.