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How many days per week would you like to run each week?
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3
4
5
6
How much time on these days do you want to devote to running? Please be as specific as possible. (Example: 30 minutes on weekdays; 60 minutes on weekends)
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What is your run goal? What upcoming race(s) do you have on your calendar? Are you aiming for a certain finish time?
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How long have you been running?
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Why do you enjoy running, or why do you want to run?
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Why have you chosen the goals you’ve chosen?
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What do you use to track your runs? (Examples: Apple Watch, Garmin, an app like Strava or MapMyRun?)
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What are all of your race times in the last year? Please provide the date of the race, the distance, and your time. If you feel a certain race time is not a good judge of your fitness (were you not feeling well that day, was it super hot that day, etc), tell me why.
What are your lifetime PRs (personal records)? Please provide the approximate date of the race, the distance, and your time.
What other training plans have you used in the past, if any?
Besides running, what other forms of exercise do you enjoy, and how often do you incorporate these exercises into your weekly routine?
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What kind of training have you been doing over the last 4 weeks as far as days per week, time per workout, pace, and mileage? If the answer is nothing or not much, don’t worry about it! Just trying to get a sense of where to begin.
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Have you had any recent injuries? If so, was the cause related to running?
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How did you hear about Mindful Marathon?
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Would you like to be added to the Mindful Marathon email list?
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Waiver of Liability, Assumption of Risk, and Indemnity Agreement
Waiver: In consideration of being permitted to participate in Coach Michelle Quirk’s training program, I, for myself, my heirs, personal representatives and assigns, do hereby release, waive, covenant not to sue and discharge Coach Michelle Quirk and Mindful Marathon LLC from liability from any and all claims including the negligence of Coach Michelle Quirk resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in the Mindful Marathon program.
Assumption of Risks: Participation in running and conditioning programs carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. I know that running is a potentially hazardous activity and certify that I am in good health and physically fit to enter into a training program. I acknowledge that I am aware of the many risks involved in athletic training in general and running training specifically, which risks include by way of example and not limitation: 1) minor injuries such as scrapes, bruises, sprains and strains, 2) more serious injuries such as joint, muscle and bone injuries, concussions and other head injuries, heat related injuries such as heat stroke and heat exhaustion, dehydration and over hydration conditions such as hyponatremia, and catastrophic injuries and conditions such as heart attacks and other conditions or injuries which could be fatal. I have read the previous paragraphs, and I know, understand, and appreciate these and other risks that are inherent in training for and participating in road, trail and track running and racing and any conditioning and cross training activities associated with that training. I hereby assert that my participation is voluntary, and that I knowingly assume all such risks.
Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD HARMLESS Coach Michelle Quirk and Mindful Marathon LLC from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney’s fees brought as a result of my involvement in Coach Michelle Quirk’s training program.
Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of Pennsylvania, and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect.
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Name
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First Name
Last Name
