Date Form Submitted

Athlete Name *

First

Last

Athlete Cell Phone *

Parent Name (if athlete a minor)

First

Last

Parent Cell Phone (if athlete a minor)

Athlete Email (or parent email if a minor) *

Email

Confirm Email

Address *

Address Line 1

City

State

Zip Code

College / University / School Name *

Height (inches) *

Weight (lbs.) *

Age *

Social Media Accounts (Instagram, Twitter, etc.)

Throws / Bats (R/L) *

R/R
L/L
L/R
R/L

Postion *

Playing Level *

Youth
High School
College
Pro

Current Year in High School / College

Highest Pro Level

Upcoming Playing Schedule

Pitcher Fastball Range (ex. 88-90)

Pitcher Fastball Peak (ex. 93)

Pitcher Max Long Toss Distance (ex. 300 ft)

Player Exit Velo

Player Throwing Velo

Strength Testing for Remote Assessments only - 5 RM

In order to evaluate your strength levels and to help prepare your training programs, we need to arrive at an estimate of the your 1RM. However, instead of asking you to enter your 1RM, we prefer to arrive at an estimate by getting your 5RM instead. Before you begin, please be sure to properly warm-up. Then work towards the heaviest possible weight for your 5RM with proper form. Be sure to allow 2-3 minutes rest between each set before adding more weight to the bar. When you feel like you have arrived at the right number, then please enter it (lbs.) for each exercise below.

DB Bench Press (5RM) - lbs.

Follow example provided.

Back Squat (5RM) - lbs.

Follow example provided, and please record a video of your 5 RM lift for later upload so that we can check for proper form on your Back Squat.

Trap Bar Deadlift (5 RM) - lbs.

Follow example provided, and please record a video of your 5 RM lift for later upload so that we can check for proper form on your Trap Bar Deadlift.

Jump Testing for Remote Assessments only

In order to evaluate your lateral strength levels and to help prepare your training programs, we need you to measure your reactive lateral jump as outlined by the video sample below. Please attempt a few times and record the longest distance (inches), when you feel like you have arrived at the right number.

Reactive Lateral Jump (inches)

Pain / Injury / Surgery Information

Recent or Current Pain (N/A if none)

Prior Injuries (N/A if none)

Prior Surgeries (N/A if none)

Do you have any medical limitations? (N/A if none)

Miscellaneous

What do you want to get out of the program?

Desired Program Start Date *

The following list of equipment is required… Foam Roller, Lacrosse Ball, Bench, Dumbbells, Squat Rack, Barbell, Plates (225 lbs. minimum), Pitchers-only - Plyo Balls (set), and Activation Band

The following list is suggested. Please select those you DO NOT have access to so we can adjust your program accordingly...

How many times per week do you plan to lift weights? *

5x
4x
3x