Raynard Tissink has become an icon

in the international Triathlon fraternity and has built up a following in

South Africa and around the world.

Questionnaire

HAVING TROUBLE COMPLETING THE ONLINE FORM?

To personalise your training programme, we need to know more about you.

Please complete the form below as thoroughly as possible.

Personal Information

Name:

Surname:

Gender:

Male

Female

Date of birth:

Phone number:

eMail address:

Address:

Country:

Programme Type

I wish to purchase a specific number of months, payable in advance at a discounted rate of:

3 to 6 months @ R400/month
7 months and more @ R350/month

Select No. of Months:

Total Due: R

I wish to purchase a Monthly Maintenance, Build Up and Race Specific Programme at R450/month.

Race Objectives

What is the distance of your primary race?
What is the date of your primary race?
What other races (dates) would you like to include in your build up to your primary race?

Please select the Monday that you would like to start your program?

Available Time For Training Per Day

Please select the number of weekly workouts that best fits your lifestyle:
• 1 - 2 hours per day (BEGINNER LEVEL)
• 2 - 3 hours per day (INTERMEDIATE)
• ELITE LEVEL
How many hours do you have available per day for training?

Fitness

What is the longest workout you can currently do at a COMFORTABLE pace?
• Run
• Bike
• Swim
Please list your current weekly mileages for the following:
• Run
• Bike
• Swim
How many years have you been racing?
Which day is best suited to doing your long bike ride or long brick?
Which day is best suited to doing your long run?
Select the number of rest days you are currently taking per week?
Are you doing any strength or gym training at present?

Sports History

Which discipline would you describe as your strongest discipline?
Which discipline would you describe as your weakest discipline?
Please list personal best to times recorded for the following:
• 5km Running TT
• 10km Running TT
• 20km Bike TT
• 40km Bike TT
• 1500m Swim
• Sprint distance triathlon
• Standard distance triathlon
• Ironman Distance triathlon

General Health

Please list any past or present medical conditions or injuries which we should be aware of:

Waiver

By following any of our triathlon training programs, you agree that you are in excellent physical health and fitness, and waive any responsibility on the part of raynardtissink.com and it’s associates for injury, loss or damage of any nature. Following the program is entirely at your own risk.

Having trouble completing our online form?

If you are having trouble completing the form online please download our questionnaire (A Microsoft Word Document), complete it and email it to info@raynardtissink.com.

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