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)

Registration 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:
Age:
Date of Birth:
Male/Female: Male || Female
Athlete's Phone Number: || Mobile? Yes || No
Alternate Phone Number: || Mobile? Yes || No
Athlete's Email address:
Alternate Email address:
Current School
(scholastic athletes):
Primary Event/Sport:
Current Health (include any current injuries or health concerns):
Additional Information:
Number of Months
for initial registration:
 2 months ($220) | 3 months ($300) 4 months ($360)
5 months ($425) | 6 months ($480)
Payment Choice: I am paying via PayPal
I am sending a check
Signature:

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