EmailMeForm
Athlete SIGN-UP Form
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Welcome to Wenzel Coaching!
Here you'll submit your contact information and select your program/service and coach. The Liability Waiver on the following page must be signed by you or signed by a guardian if you are under 18 years of age.
You can save and resume your form at any time. Just make sure to return within 7 days to finish and submit your form to avoid losing your entered information.
Use only the “Next Page” and “Previous” buttons at the bottom of the form to navigate within the form. Hitting your browser buttons will lose your form place and data!
Contact Information
First Name
*
Name or Nickname of client or person receiving service.
Last Name
*
Email
*
Main Phone
*
###
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###
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####
Secondary Phone
Skype, Facetime or other video conference handle
Please note which service the handle is for.
Street Address
*
City
*
State
*
Abbreviation
Postal Code
*
Country
Birth Date
*
MM
/
DD
/
YYYY
Sex
Female
Male
Emergency Contact
Emergency Contact Phone
Club
Your riding, racing, triathlon or running club, if any.
I am a member of a Wenzel Coaching Sponsored Club
*
No
Yes
Sponsored Club Code
Please enter your sponsored club code. The correct code is required to continue the form with sponsored club pricing.
All sponsored club riders will be confirmed as active club members before allowed to receive a training program at sponsored club pricing. Knowledge of the club code does not guarantee club pricing.
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Be sure to use only the
“Next Page” and “Previous”
buttons at the bottom of the form
to navigate within the form.
Hitting your browser buttons will lose your form place and data!
Total
$0.00
