Spring/Fall Training Profile Form

To participate in the 2008 Spring and/or Fall Workout program, complete the form below and mail it with your payment made out to MVS for Levels 1 and 2 and to Fernando Braz for Level 3. Mail to MVS, 81 Main Street, Peabody, MA 01960
You may fill in the form online and then print it, or you may print it out and then complete it. Note that if you fill it out online, only what is displayed in the text boxes will print.

Name: Date of Birth
Address:
Phone Number:
E-mail address:
Short Term Goal:
Last 3 Months Racing Results:
Weekly mileage for last month: # Days per week you can train:
# Weekly miles you want to achieve:
Planning a duathlon/triathlon? If yes, which ones:
Days per week you plan to Swim Bike Run
Injury Update:
Current Workout Group:
[if applicable; for example, 2 or F]
Program: Spring E-mail program
Level 1, $45 [includes $5 facility fee]
Level 2, $80 [includes $5 facility fee]
Level 3, $65 per month		 Fall E-mail program
Level 1, $45 [includes $5 facility fee]
Level 2, $80 [includes $5 facility fee]
Level 3, $65 per month
Amount enclosed:
[facility fee not required for email program]
Signature: