Information Name * First Name Last Name Date of Birth MM DD YYYY Email * Phone (###) ### #### How much experience do you have with resistance training? Do you have any current/past injuries or movement issues that need to be taken into account when training? What goal(s) can I help you meet? What’s your favorite drink and snack? I hereby grant Build Performance permission to use my likeness in a photograph, video, or other digital media (“photo”) in any and all of its publications, including web-based publications, without payment or other consideration. I agree I do not agree Thank you!