Name *

First Name

Last Name

Gender *

Male

Female

Other

Birthday *

MM

DD

YYYY

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Phone Number *

(###)

###

####

Emergency contact phone *

Mandatory for your 20km of Brussels registration

(###)

###

####

Physical Activity *

Poor

Light

Weekly

Heavy

Do you own a GPS watch? *

Yes

No

T-shirt size *

SMALL

MEDIUM

LARGE

XLARGE

Socks size *

34/37

38/41

42/46

The questionnaire you have just completed is intended to optimize your care. However, unless you provide a certificate of 'no contraindication to practicing sports' dated less than a year ago or a photocopy of a valid sports license, you are responsible for your own health. By participating in the sports coaching sessions with Cadence Athletics, you do so at your own risk. You attest that you have no contraindications to practicing sports, thereby waiving any right to recourse against the professional in charge and Cadence Athletics.. *

I agree with the above statement

By checking this box, I commit to respecting the copyright and intellectual property of the coach, Cadence Athletics, in relation to the personalized training plan provided. I understand that the plan is intended for personal use and that any reproduction, distribution, or sale of the content is strictly prohibited *

I agree with the above statement