Exit Para Powerlifting Intake Form Question Title * 1. Name Question Title * 2. Email Question Title * 3. Phone Question Title * 4. Gender Male Female Non-binary Question Title * 5. Address Question Title * 6. What level of experience do you have performing a bench press? Question Title * 7. Do you have a lower body impairment? Explain. If unsure if you qualify let us know in the comment section below. Question Title * 8. Do you currently compete in another sport? Yes No Prefer not to say Question Title * 9. Any health restrictions or concerns you would like us to be aware of? Question Title * 10. What statement describes you best: I want to know more about the sport I want to have fun or try something new I'm interested in competing Other (please specify) Done