Name *

First Name

Last Name

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Shirt Size

Small

Medium

Large

X-Large

XX-Large

Primary Race Distance Goal *

This is the race for which you wish to peak. You may have other races leading up to this race, but this is your primary goal. Don't have a race goal yet? Read our post about setting good race goals

Sprints (100m, 200m, 400m)

Middle-distance (800m, 1500m, 1600m)

5K

10K

Half-Marathon

Marathon

50k

50 Mile

100k

100 Mile

Other

Date of Race Goal

The best goals are time bound. To give you time to prepare your goal race should be 3 to 5 month out.

MM

DD

YYYY

Has your doctor ever said that you have a heart condition and that you should only perform physical activity recommended by a doctor?

Yes

No

Do you feel pain in your chest when you perform physical activity?

Yes

No

In the past month, have you had chest pain when you were not performing any physical activity?

Yes

No

Do you lose your balance because of dizziness or do you ever lose consciousness?

Yes

No

Do you have a bone or joint problem that could be made worse by a change in your physical activity?

Yes

No

Is your doctor currently prescribing any medication for your blood pressure or for a heart condition?

Yes

No

Do you know of any other reason why you should not engage in physical activity?

Yes

No

Terms of Service *

I agree to the Terms of Service