Cerebral Sports - Respect * Trust * Results
 
Sign Up!
 
        
       
 
 
 
Don't Wait and Lose Your Chance! 
 
Don't wait until one of your competitors hires me to take your wins away from you. Call me now to get started with your consultation.
 
Before you pick up that phone, or e-mail, I have to tell you that I won't work with just anyone. Please do NOT call if you aren't as serious as I am.
 
I also won't work with someone if I feel I can't help them increase their performance. I have to be upfront about that. I don't want your money if I can't help you.
 
<form action="//submit.form" id="SignUp100" method="post" onsubmit="return ValidateForm(this);">
< script type="text/javascript">
function ValidateForm(frm) {
if (frm.FirstName.value == "") { alert('First Name is required.'); frm.FirstName.focus(); return false; }
if (frm.LastName.value == "") { alert('Last Name is required.'); frm.LastName.focus(); return false; }
if (frm.FromEmailAddress.value == "") { alert('Email address is required.'); frm.FromEmailAddress.focus(); return false; }
if (frm.FromEmailAddress.value.indexOf("@") < 1 || frm.FromEmailAddress.value.indexOf(".") < 1) { alert('Please enter a valid email address.'); frm.FromEmailAddress.focus(); return false; }
if (frm.StreetAddress1.value == "") { alert('Address is required.'); frm.StreetAddress1.focus(); return false; }
if (frm.City.value == "") { alert('City is required.'); frm.City.focus(); return false; }
if (frm.Country.value == "") { alert('Country is required.'); frm.Country.focus(); return false; }
return true; }
< /script>
< table border="0" cellpadding="5" cellspacing="0" width="600">
<tr> <td>
<label for="FirstName">First</label>, <label for="LastName">Last Name*:</label>
</td> <td>
<input name="FirstName" type="text" maxlength="60" style="width: 146px;" />
<input name="LastName" type="text" maxlength="60" style="width: 146px;" />
</td> </tr> <tr> <td>
<label for="Organization">Organization:</label>
</td> <td>
<input name="Organization" type="text" maxlength="60" style="width: 300px;" />
</td> </tr> <tr> <td>
<label for="FromEmailAddress">Email address*:</label>
</td> <td>
<input name="FromEmailAddress" type="text" maxlength="60" style="width: 300px;" />
</td> </tr> <tr> <td>
<label for="WorkPhone">Work Phone:</label>
</td> <td>
<input name="WorkPhone" type="text" maxlength="43" style="width: 250px;" />
</td> </tr> <tr> <td>
<label for="HomePhone">Home Phone:</label>
</td> <td>
<input name="HomePhone" type="text" maxlength="43" style="width: 250px;" />
</td> </tr> <tr> <td>
<label for="CellPhone">Cell Phone:</label>
</td> <td>
<input name="CellPhone" type="text" maxlength="43" style="width: 250px;" />
</td> </tr> <tr> <td>
<label for="Fax">Fax:</label>
</td> <td>
<input name="Fax" type="text" maxlength="43" style="width: 250px;" />
</td> </tr> <tr> <td>
<label for="StreetAddress1">Address 1*:</label>
</td> <td>
<input name="StreetAddress1" type="text" maxlength="120" style="width: 350px;" />
</td> </tr> <tr> <td>
<label for="StreetAddress2">Address 2:</label>
</td> <td>
<input name="StreetAddress2" type="text" maxlength="120" style="width: 350px;" />
</td> </tr> <tr> <td>
<label for="City">City*:</label>
</td> <td>
<input name="City" type="text" maxlength="120" style="width: 300px;" />
</td> </tr> <tr> <td>
<label for="State">State/Province:</label>
</td> <td>
<input name="State" type="text" maxlength="120" style="width: 300px;" />
</td> </tr> <tr> <td>
<label for="Zip">Zip/Postal Code:</label>
</td> <td>
<input name="Zip" type="text" maxlength="30" style="width: 100px;" />
</td> </tr> <tr> <td>
<label for="Country">Country*:</label>
</td> <td>
<input name="Country" type="text" maxlength="120" style="width: 300px;" />
</td> </tr> <tr> <td>
* - required fields
</td> <td>
<div style="float: right">
<a href="https://www.100forms.com" id="lnk100" title="web forms">forms</a></div>
<script src="https://www.100forms.com/js/FORMKEY:NLYTPW7RQJY8/SEND:
sportstraining@aol.com
" type="text/javascript"></script>
<input name="skip_Submit" type="submit" value="Submit" />
</td> </tr>
< /table>
< /form>