Athlete Intake Form

6-Week Mentorship, Parent Submission

Athlete First Name

Athlete Last Name

Athlete Email

Parent First Name

Parent Last Name

Parent Email

Athletes Age

Organization/Team

City/State

What do you hope your athlete will gain from this coaching experience?

What are the biggest mindset challenges your athlete currently faces in her sport? (ie Confidence, performance anxiety, self-talk, response to mistakes, leadership skills, fear of failure etc ... Please list all that apply in order of importance)

Are there any patterns, behaviors, challenges you've noticed that you think she might not be fully aware of yet?

What one mindset transformation do you think would be the most beneficial for your daughter?

Is there anything else you would like me to know about your daughter that would help me serve her better?

Do you give your daughter permission to receive and send texts for our Group Mentorship program? (Texts sent will be during our 6wks together and for the purpose of encouragement, follow ups and group reminders.)

Athlete Cell *If checked 'YES' for group mentorship texts

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Athlete Intake Form

CONNECT WITH ME ON

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