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Your coaching payment will be due at your first coaching session.

Questions? Email Coach Judi at: jcarbary@gmail.com

Name

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Address

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City

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Health Status/Conditions/Injuries

Athletic Experience

Biking (years, usual mileage/wk, speed mph) Swimming (years, swim team, usual yds/wk, time/yds) Core/Strength training (years, times/wk)

Interest