Personal Coaching Signup
1. Go to sign-up steps for program details.
2. Go to sign-up form to register (send form via Internet or mail)
3. Go to program payments to submit payment via Internet (or mail payment with form)

Sign-Up Form

To participate in the Going the Distance Personal Coaching program, complete the form below.

You may submit the form online by clicking the Submit Profile Form button, or you may print and mail it with your payment, made out to Going the Distance. Send to: Going the Distance, 29 Buckingham Road, N. Andover, MA 01845
You also may submit payments via PayPal by going to the Going the Distance Program Payments page.

Name:
Address:
City/State/Zip:
Date of Birth:
Phone Number:
E-mail address:
Program Goal: Racing (specify race(s) or distance(s) below
Maintenance
Racing Goal (if applicable):
What is your current long run distance?:
Race results in last 2 months. If no race results, what is a workout pace effort you want to achieve?
Weekly mileage for last month:
# Days per week you can train:
# Weekly miles you want to achieve by end of the program:
Injury Update:
Number of Months
for initial registration:
1 month ($90) | 2 months ($180) | 3 months ($240)
4 months ($320) | 5 months ($375) | 6 months ($420)
Payment Choice: I am paying via PayPal
I am sending a check
Signature:

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