Smurf Endurance Sports - 70.3/Ironman Cairns Program

Registration

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* 1. Full Name (First and Last)

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* 2. Date of Birth

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* 3. Gender Identity

Female

Male

Non-Binary

Other

Prefer not to disclose

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* 4. Contact Number

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* 5. Email Address

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* 6. Emergency Contact

Name

Number

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* 7. Rate your current level of fitness on a scale from 0-10

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 8. Rate your triathlon experience on a scale from 0-10

Clear

i We adjusted the number you entered based on the slider’s scale.

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* 9. Describe your recent triathlon/sport/exercise experience

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* 10. Please select any of the following medical issues which may impact on your training

	Yes	No
Blood Pressure, stroke or blood disorders	?Blood Pressure, stroke or blood disorders ?Yes	?Blood Pressure, stroke or blood disorders No
Heart Problems	Heart Problems ?Yes	Heart Problems No
Current Injuries	Current Injuries ?Yes	Current Injuries No
Recent Operations	Recent Operations ?Yes	Recent Operations No
Diabetes on Insulin	Diabetes on Insulin ?Yes	Diabetes on Insulin No
Musculoskeletal Issues	Musculoskeletal Issues ?Yes	Musculoskeletal Issues No
Current Medications	Current Medications ?Yes	Current Medications No
Other	Other ?Yes	Other No

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* 11. If you answered yes to any of question 10, please provide a brief description

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* 12. What is motivating you to engage in this triathlon program?

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* 13. What distance are you planning for Ironman Cairns?

Team

70.3

Ironman

Now you have completed the program registration survey, please go to THIS LINK to purchase your membership.

We also use TrainingPeaks to deliver our programs. Either link your current account HERE or create an account HERE, then link it to our coach account using THIS LINK.

Within 24 hours of completing the registration survey, you will receive a confirmation email with further details. Congratulations on signing up!!