Smart Velo Registration Form The Baseball Zone » Smart Velo Registration Form "*" indicates required fields Athlete's Name* First Last Date of Birth MM slash DD slash YYYY Height Weight Mailing Address Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Contact InfoCurrent Team Home PhoneCell Phone*Email* Parent's Name(s) Parent(s) Emails QuestionsHow did you hear about the Smart Velo Project?Why do you feel that this program is right for you and what are your short and long-term pitching aspirations?Years Pitching experience Private/Semi-Private lessons before Yes NO Previous Instructor(s)Approximately how many lessons did you receive?Over what period of time? Last radar MPH reading (if known): How often do you practice pitching on your own? Less than once every 2 weeks Once every 2 weeks Once every week A couple times every week Almost every day If you fail to pitch well this happens most often: I get hit hard I walk a lot of people Other If Other SpecifyIf you fail to hit your location, you miss: Mostly High Mostly Low Mostly Inside Mostly Outside Varible If you struggle in a game…..it is usually: Early – you can’t get in the groove Late – you start strong but fade as you go Other If Other SpecifyI have experienced arm soreness: In my elbow In my shoulder Never Other If Other SpecifyI would rate the pain of my arm soreness at its worst in the previous question as a: 10 Excruciating 8 Severe 6 Considerable 4 Moderate 2 Mild 0 Very rarely, almost never If you saw a doctor for the pain, his/her diagnosis and suggestions was:Please list any other injuries you have sustained in the past:Are there any other current injuries or limitations that we should be aware of?On the team I pitch, currently I am: The ace and workhorse of the staff One of the top pitchers-a key member of the staff One of the role pitchers I get very limited pitching time When I get to pitch, my pitch count is limited to: 100+ 100 90 80 70 60 I would consider myself: An exceptionally serious student of pitching A serious student of pitching A part time student of pitching Just a pitcher, not a student of pitching Complete the following sentence: I would know I was a successful pitcher if I could…..Have you trained in a throwing/ pitching program? If so, please list the details of with whom, when and how frequently:Have you participated in a strength training program? If so, please list the details of with whom, when and how frequently:What have you done or are currently doing with regards to nutrition?Do you have any additional questions?
