tag:blogger.com,1999:blog-43071297178580374362011-07-08T01:44:20.954-07:00André Palermo Szücshttp://www.blogger.com/profile/12252293114335008140noreply@blogger.comBlogger11100tag:blogger.com,1999:blog-4307129717858037436.post-49192736872168151282010-06-28T11:48:00.001-07:002010-06-28T11:48:38.142-07:00English version: <a href="http://www.royaltri.com/2010/04/athletic-history-form.html">Athletic History Form</a><br /><br /><form enctype="multipart/form-data" method="post" action="http://www.emailmeform.com/builder/form/434593"><table style="color: rgb(255, 255, 255);" bg="" border="0" cellpadding="2" cellspacing="0"><tbody><tr><td style="" colspan="2"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><br /></span></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Seu nome:</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_0" name="element_0" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Datas de nascimento</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_1" name="element_1" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Telefone residencial/celular</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_2" name="element_2" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Endereço</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_3" name="element_3" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Cidade</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_4" name="element_4" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Estado</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_5" name="element_5" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>email</b></span><span style="color:red;"><small>*</small></span></td><td style=""><input id="element_6" name="element_6" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>CPF</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_7" name="element_7" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Sua foto em boa resolução:</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_8" name="element_8" type="file"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Como chegou à Royaltri?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_9" name="element_9" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Você possui alguma dessas contas de email?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_10" name="element_10"><option value="-" selected="selected">-</option><option value="gmail.com">gmail.com</option><option value="hotmail.com">hotmail.com</option><option value="nenhuma das duas">nenhuma das duas</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Atualmente você treina com algum grupo</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_11" name="element_11"><option value="-" selected="selected">-</option><option value="Sim">Sim</option><option value="Não">Não</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Se Sim, que tipo de grupo?</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_12" name="element_12" cols="30" rows="5"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Você prefere que eu seu treino seja planejado por<br />competição alvo?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_13" name="element_13" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Selecione o tipo de treino desejado:</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_14" name="element_14"><option value="-" selected="selected">-</option><option value="Alto rendimento">Alto rendimento</option><option value="treino de manutenção">treino de manutenção</option><option value="emagrecimento">emagrecimento</option><option value="condicionamento físico">condicionamento físico</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Qual tipo de prova que você deseja competir?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_15" name="element_15"><option value="-" selected="selected">-</option><option value="IronMan (3,8km/190km/42km)">IronMan (3,8km/190km/42km)</option><option value="Meio IronMan (1,9km/90km/21km)">Meio IronMan (1,9km/90km/21km)</option><option value="Triathlon Olímpico (1,5km/40km/10km)">Triathlon Olímpico (1,5km/40km/10km)</option><option value="Sprint Triathlon (750m/20km/5km)">Sprint Triathlon (750m/20km/5km)</option><option value="Maratona">Maratona</option><option value="Meia Maratona">Meia Maratona</option><option value="10km">10km</option><option value="5km">5km</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Você possui algum objetivo de longo prazo?</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_16" name="element_16" cols="30" rows="5"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quantas sessões de cada modalidade você deseja<br />por semana?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_17" name="element_17"><option value="-" selected="selected">-</option><option value="Iniciante: 2 bike,2 corrida, 2 natação">Iniciante: 2 bike,2 corrida, 2 natação</option><option value="Interm: 3 bike,3 corrida,3 natação">Interm: 3 bike,3 corrida,3 natação</option><option value="Alto rend: 4 bike,4 corrida,4 natação">Alto rend: 4 bike,4 corrida,4 natação</option><option value="não se aplica">não se aplica</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quanto anos de experiência com competições?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_18" name="element_18" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quantas sessões de treinamento por semana você<br />fez neste ano?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_19" name="element_19" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quantas sessões de treinamento por semana você<br />fez no ano passado?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_20" name="element_20" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Qual o seu ritmo de corrida min/km nos 10km?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_21" name="element_21" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Qual o seu melhor tempo nos 100m livre (piscina<br />25m)?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_22" name="element_22" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Qual o seu melhor tempo nos 200m livre (piscina<br />25m)?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_23" name="element_23" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quando você prefere fazer o seu treino longo de<br />natação?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_24" name="element_24"><option value="-" selected="selected">-</option><option value="Segunda">Segunda</option><option value="Terça">Terça</option><option value="Quarta">Quarta</option><option value="Quinta">Quinta</option><option value="Sexta">Sexta</option><option value="Sábado">Sábado</option><option value="Domingo">Domingo</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quando você prefere fazer o seu treino longo de<br />Bike?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_25" name="element_25"><option value="-" selected="selected">-</option><option value="Segunda">Segunda</option><option value="Terça">Terça</option><option value="Quarta">Quarta</option><option value="Quinta">Quinta</option><option value="Sexta">Sexta</option><option value="Sábado">Sábado</option><option value="Domingo">Domingo</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quando você prefere fazer o seu treino longo de<br />corrida?</b></span><span style="color:red;"><small></small></span></td><td style=""><select id="element_26" name="element_26"><option value="-" selected="selected">-</option><option value="Segunda">Segunda</option><option value="Terça">Terça</option><option value="Quarta">Quarta</option><option value="Quinta">Quinta</option><option value="Sexta">Sexta</option><option value="Sábado">Sábado</option><option value="Domingo">Domingo</option></select><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quais os dias da semana que você prefere fazer<br />musculação?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_27" name="element_27" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Quais os dias da semana que você prefere para<br />descansar?</b></span><span style="color:red;"><small></small></span></td><td style=""><input id="element_28" name="element_28" value="" size="30" type="text"><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Você utiliza outros tipos de monitoramento para<br />seu treino?<br />(GPS/ SRM/ PowerTap/ i bike)</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_29" name="element_29" cols="30" rows="5"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Você utiliza monitor cardíado em suas sessões<br />de treinos? Qual marca/modelo?</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_30" name="element_30" cols="30" rows="5"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Nos informe de todos os eventos que você planeja<br />competir esse ano: incluir:<br />-Nome do evento<br />-<br />local<br />- data<br />- distância<br />- prioridade</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_31" name="element_31" cols="30" rows="10"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr valign="top"><td style="" align="left"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><b>Informações complementares:</b></span><span style="color:red;"><small></small></span></td><td style=""><textarea id="element_32" name="element_32" cols="30" rows="10"></textarea><br /><br /><div style="color: rgb(0, 0, 0);"><small></small></div></td></tr><tr><td colspan="2" align="right"><input name="element_counts" value="33" type="hidden"><input value="Enviar" type="submit"><input value="Limpar" type="reset"></td></tr></tbody></table></form><div><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"><br /></span><a style="text-decoration: none;" href="http://www.emailmeform.com/" target="_blank"><span style="color: rgb(0, 0, 0);font-family:Arial;font-size:78%;"></span></a></div><div class="blogger-post-footer"><img width='1' height='1' src='https://blogger.googleusercontent.com/tracker/4307129717858037436-4919273687216815128?l=questionarioroyaltri.blogspot.com' alt='' /></div>André Palermo Szücshttp://www.blogger.com/profile/12252293114335008140noreply@blogger.com