Name *

First Name

Last Name

Preferred Method of Contact *

Phone

Email

Have you ever competed in Powerlifting? *

Yes

No

On a scale of 1-5, how strenuous is your occupation? *

1 - Not Strenuous

2 - Not Very Strenuous

3 - Average

4 - Pretty Strenuous

5 - Very Strenuous

On a scale of 1-5, how would you rate your diet? *

1 being no structure at all, and 5 being meal timing and macro counting.

1 - No Structure

2 - Little Structure

3 - Average Structure

4 - Moderate Structure

5 - Rigid Structure

Do you Squat High Bar or Low Bar? *

High Bar

Low Bar

Sumo or Conventional Deadlift? *

Sumo Deadlift

Conventional Deadlift

Are you able to film your lifts? *

Yes

No