Client Intake Form

Step 1 of 9 - BASIC INFORMATION

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This field is for validation purposes and should be left unchanged.

Name(Required)

First Last

Email Address(Required)

Phone Number(Required)

Date of Birth(Required)

MM slash DD slash YYYY

Current School(Required)

Grade Level(Required)

Expected Graduation Year(Required)

City/Town(Required)

State(Required)

Primary Sport(Required)

Please Specify(Required)

Position(s) You Play(Required)

Do you play multiple sports?(Required)

Yes

What other sports?(Required)

Current Team(s)(Required)

Years Playing This Sport(Required)

Current Athletic Stats (if applicable)

Are you currently doing any training outside of team practice?(Required)

Yes

What type of training?(Required)

Strength training

Speed/agility training

Sport-specific skills coaching

Personal training

Other

How many hours per week do you currently train (outside of team practice)?(Required)

Have you worked with a personal trainer or sports performance coach before?(Required)

Yes

Please describe:(Required)

Current GPA(Required)

Have you taken the SAT or ACT?

Yes

Not Yet

Planning to

If yes, what are your scores?(Required)

Are you on track academically to graduate on time?(Required)

Yes

Unsure

Do you currently need academic support?(Required)

Time management

Study skills

Maintaining eligibility

Understanding NCAA requirements

Not at this time

Other

What are your athletic goals for the next 6 months?(Required)

What are your long-term athletic goals?(Required)

Are you interested in playing sports in college?(Required)

Yes

Definitely

Maybe

Not sure yet

What division level are you targeting?(Required)

Division I

Division II

Division III

NAIA

Junior College

Any level

Not sure yet

What do you most want to improve?(Required)

Select up to 3 choices.

Speed

Strength

Agility/Quickness

Endurance/Conditioning

Sport-specific skills

Mental toughness

Consistency

Injury prevention

Nutrition/Diet

Other

Have you started the college recruiting process?(Required)

Yes

Not applicable (not interested in college sports)

Where are you in the process?(Required)

Created highlight videos

Built recruiting profile

Contacted coaches

Attended camps/showcases

Receiving interest from colleges

Have offers

Just getting started

Are college coaches currently watching you or showing interest?(Required)

Yes

Not sure

Which schools?

Do you need help with recruiting?(Required)

Creating highlight videos

Building recruiting profile

Contacting coaches

Understanding the process

Finding the right schools

All of the above

Not at this time

Are you currently injured or recovering from an injury?(Required)

Yes

Please describe:(Required)

Do you have any health conditions we should know about?(Required)

Yes

Please describe:(Required)

How many days per week can you commit to training?(Required)

What times work best for you?(Required)

Early morning (before school)

After school (3-6pm)

Evening (6-8pm)

Weekends

Flexible

What is your preferred training location?(Required)

Partner facility near me

Mobile training (coach comes to me)

Either works

Not sure yet

Parent/Guardian First Name(Required)

Parent/Guardian Last Name(Required)

Parent/Guardian Email(Required)

Parent/Guardian Phone(Required)

Relationship to Athlete(Required)

How did you hear about Main Stage Athletics?(Required)

If referred by someone, who can we thank?

What Main Stage services are you most interested in?(Required)

Performance Training

Personal Coaching

Recruiting Help

Athletic Support Services

Not sure yet

Is there anything else we should know about you or your goals?(Required)

Consent & Agreement(Required)

I confirm that the information provided is accurate. I understand that Main Stage Athletics will use this information to contact me about their services and create a personalized training plan. I agree to receive emails and phone calls from Main Stage Athletics.

New Client Intake - Main Stage Athletics

Client Intake Form