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6 Week Challenge Pre-Assessment Form

This form is used to gather relevant information before you come in for your assessment. Take the time to provide us with as much information and detail as possible. Thank you!

Parent/guardian first name*

Parent/guardian last name*

Player name (first, last)*

Player D.O.B. *

Month

Day

Year

Player's current team*

Which division/tier does your son/daughter currently play? AAA, Yzerman, Howe 1/2/3, House, Tier 2/3 (girls)*

Which program(s) are you interested in?*

Skill Development

Off-Ice Training

Both

What are your short-term goals? List 1-3 goals your son/daughter would like to accomplish in the next 2-3 months?*

What are your long-term goals? List 1-3 goals your son/daughter would like to accomplish in the next 1-2 years.*

What is the end goal? How far does your son/daughter hope to make it in their hockey career?*

What is your own assessment of your son/daughter's current hockey skills and athletic abilities?*

Do you believe your son/daughter is able to achieve their short and long-term goals on their own?*

Yes

If yes, why? If no, why not?*

What is the main reason you are looking to train right now?*

Has your son/daughter struggled to be consistent in their own practice and/or training in the past?*

Yes

Do you believe that your player will get better results with proper coaching, support, and accountability?*

Yes

When are you be able to begin training?*

Right away

In a couple weeks

In a month or more

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