Esports Performance Training Intake Form For individuals, teams and coaches. Please message us on Discord with any questions. Name:* First Last Birthdate:* MM slash DD slash YYYY Are you under 18 years old?* No Yes Parent/guardian please sign and enter email address:* Discord Username + Tag:* Discord is our primary communications method. Please enter your full Discord name + 4 digit tag (ex: Agragati#7539)Email:* Cellphone:Only used for appointment reminders. Optional.Country:*Choose a CountryUnited StatesAfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongo, Democratic Republic of theCongo, Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzech RepublicCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatini (Swaziland)EthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacauMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth KoreaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaRéunionSaint BarthélemySaint HelenaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth GeorgiaSouth KoreaSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan Mayen IslandsSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTurks and Caicos IslandsTuvaluUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUruguayUzbekistanVanuatuVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland IslandsYour Time Zone and Preferred Time Of Contact:* For example: PST (GMT-7), weekdays after 4pm and all weekend.Where Did You Hear About Us?*ChooseGoogleGameSync Discord ServerOther Discord ServerFriendFacebook GroupTwitterEmail From GameSyncFlyer / Poster At GameSync Esports CenterOtherFacebook Group Name: Enter the link to the Facebook group or the group name if you can remember it.Discord Server Name: Enter the link to the Discord server or the name if you can remember it.Your Friend's Discord Name: If your friend wants to be contacted, please provide their full Discord name.Other: What Do You Wish To Accomplish In Esports? Choose All That Apply:* Go Pro/Semi-Pro Compete in tournaments online Compete in LAN tournaments at physical locations Play casually for fun Stream as a career Can You Attend Local Programs At GameSync Esports Center?* Yes No We are located in San Diego, CA, USA.Days And Times You Are Most Available:* How Many Hours Do You Invest In Gaming Daily/Weekly:* Your Gaming History & Current Goals:*Please give a brief background of your gaming history and what you're trying to achieve now.Have You Ever Played In A Tournament Or League Before?* Yes No Describe Your Tournament and/or League Experience:*Have You Ever Worked With An Esports Coach or Mental Skills Trainer Before?* Yes No Describe Your Experience:*Exercise/Work Activity/Habits/Injuries You've Had:*Do You Have Any Experience With Meditation, Mindfulness, or Breathing Techniques?* Yes No Describe Your Experience:*Rate the Following Mental Skills From 1 (None) to 10 (Perfect):Focus/Concentration:*Choose12345678910How well are you able to block out distractions and keep your focus during matches?Stress Management:*Choose12345678910How well do you manage your nerves during competitive gaming?Energy Management:*Choose12345678910Do you have the ability to not come out too hot/hyped up and lose all your energy prematurely? Do you come out too cold?Breath Control:*Choose12345678910In matches, do you breathe or hold your breath? Do you breathe too heavily?Goal Setting:*Choose12345678910Do you set goals that are challenging, realistic, time based, measurable, and obtainable?Adaptability/Problem Solving:*Choose12345678910Can you change up strategy during competition and change style based on opponent, as well as your environment/surroundings? Ex: home vs. an arena/stage.Imagery/Visualization:*Choose12345678910How is your ability to use your senses to optimize your performance? Ex: imagine yourself pulling off a successful move - can you visualize what you feel, how the controller feels in your hand, what would you do if you played a certain person, etc.Confidence:*Choose12345678910How confident are you in your ability to perform?Esports TeamAre You Or Were You Part of An Esports Team At Any Time:* No Yes Team Name(s):* What Was/Is Your Role:* For example: leader, support, etc.Roster For Group Coaching: If you're part of an already formed team or group of friends who want to or are playing together, enter the roster and full discord names (with 4 digit tags) of the other players if you'd like us to contact them about holding group coaching sessions.Rate the Following Skills From 1 (None) to 10 (Perfect):Team Synergy/Cohesiveness With Teammates:*Choose12345678910How well do you work with your teammates? Do you communicate well? Is one person doing more than the other? Do you feel chemistry between teammates? Synergy is the concept that the value and performance of a combined team will be greater than the sum of the separate individual parts. Synergy results in high productivity, efficiencies and accountability.Communication With Teammates:*Choose12345678910Chemistry Between Yourself and Teammates:*Choose12345678910Chemistry is the feeling of connection, of wanting to spend more time with a person.Help Us ImproveWe want to serve you and everyone better! Click "yes" below to show additional questions.Show Optional Fields: No Yes Facebook/Twitter/Google Usernames: Please enter one or more usernames and corresponding social network names. May be shared with your team. Example: facebook.com/JoeBob13Video Portfolio Links: Add any links to your video portfolios: Twitch, Youtube, etc.Additional Contact Methods: Please include social network name and your username. For example: Snapchat JoeBob13Preferred Method Of Contact: For example: phone (text), phone (voice), Skype, etc.School You Attend: We occasionally offer schools the chance to compete against each other in county-wide tournaments.Your Favorite Snacks/Candy/Drinks: We use this feedback to help choose what snacks and drinks to offer at our esports center.Game InformationPrimary game you play:*Choose a GameCall of DutySmash UltimateValorantLeague of LegendsFortniteCounter-StrikeOverwatchMinecraftRocket LeagueApex LegendsPUBGDoTA 2HearthstoneHeroes of the StormFGCOtherOther game name:* Estimated total number of hours in the game:* Similar Titles You've Played and Estimated Total Number of Hours:* Specific skills you want to work on* Kill/Death (K/D) Ratio:*All-time High (ATH) Kills In A Match:*Aiming Skills:*12345678910Summoner Name:* Your Current Rank:* For example: Silver II, Platinum I, etc.Your Highest Rank Achieved (optional): Your Current Level:* 30 Below 30 If you are below level 30, you will be placed in an up-and-coming player's group and/or general meetup group where more advanced players will assist you to level up.Position(s) You Mainly Play:* Any ADC Mid Top Jungle Support If you're not sure on your position of play, select "any."What Role Do You Play:*Choose RoleDuelistInitiatorSentinelControllerGamertag/PSN name:* Types of Match(es) You Typically Play:* Select All Solo Duos Squad In-Game Name:* Your Steam Profile URL:* For example: http://steamcommunity.com/profiles/76561198098318393/Current Rank:* If you don't play matchmaking (for example, you play ESEA only), mention it here.Highest Rank Achieved (optional): Position(s) You Typically Play:* Any IGL Entry Support AWP Secondary AWP Lurker If you're not sure on your preferred position of play, select "any."Professional Match Experience (ESEA/CEVO/FaceIt): If you have played any ranked matches, please describe the league you played in and the outcome.Who Is Your Main?* Do You Play Smash Online?* Yes No What's your GSP? If you play 1v1, this can be ignoredDescribe Your Smash Skill LevelSpacing:* Off-stage:* Neutral:* Disadvantage:* Advantage:* Not Dropping Combos:* DI (Directional Influence):* Conditioning:* Doing certain things to make your opponent comfortable/predictable.Footsies:* Positioning your character in and out of threat ranges.Battletag:* Your Current Skill Rating:* For example: 3510Your Highest Skill Rating (optional): Position(s) You Typically Play:* Any DPS Tank Offtank/Flex Support If you're not sure on your preferred position of play, select "any."Current Solo MMR:* Highest Solo MMR Reached (optional): Position(s) You Play, In Order Of Preference:* For example: Carry>Mid>Offlane>Support>Hard Support. If you're not sure on your position of play, put "any."Position(s) You Are Applying For:* Any Carry Mid Offlane Support Hard Support If you're not sure on your position of play, select "any."What Is your Rank?* 25 to 1 or Legend. If you do not play ranked games, please indicate so.How Long Have You Been Playing?* Team Type* 3 Person Team 5 Person team Individual Individual + 3 Person Team Individual + 5 Person Team You can be on a team or solo, or both!Platform:*PCPS4XBOX ONEYour Steam Account ID:* For example: http://steamcommunity.com/profiles/76561198098318393/Your PlayStation Network ID:* Your XBOX One ID:* Highest Competitive Matchmaking Rank In Any Queue*UnrankedProspect IProspect IIProspect IIIProspect EliteChallenger IChallenger IIChallenger IIIChallenger EliteRising StarShooting StarAll-StarSuperstarChampionSuper ChampionGrand ChampionOnline Tournament Experience:If you have participated in ESL, Gfinity, Mockit, PPL, VvV, RLC, or other tournaments, please detail which tournaments, and please list any top 8 finishesSeason You Started Playing In:* Options are from season 1 all the way up to the current season.Preferred Legend/Main:* Options are from season 1 all the way up to the current season.Preferred Game Mode:*ChooseCasual TriosCasual DuosRanked TriosRanked DuosArenasRanked ArenasTotal Damage:* Total Wins:* Kill/Death Ratio:* Matches Played:* If you click on your name in the game, you will see precisely how many matches you have played.Current Rank:* Highest Recorded Rank:* Your In-game Battle Tag:* How others see your name in-gameRoles You Play (In Order Of Preference):* For example: Assassin > Specialist > Support > WarriorYour Current Player Level:* Enter a number between 1 and 40Your Current Team League Rank:* Enter a number between 1 and 50Your Placement Rank:* You must play 20 ranked games for the system to calculate your MMR. This becomes your default rank.Games Won This Season:* Check in-game statistics to get this number.Most Kills As (Optional): Which hero did you have your best moments with? Check in-game statistics to get this number.Most Assists As (Optional): Which hero has helped others to have their best moments? Check in-game statistics to get this number.Most Deaths As (Optional): Which hero did you have your worst moments with? Check in-game statistics to get this number.Your Best Map (Optional): The map where you totally rock! Check in-game statistics to get this number.Your Worst Map (Optional): The map where you don't totally rock at all! Check in-game statistics to get this number.Most Played Heroes This Season (Optional): This is just for fun, to know your top hero choices. Check your profile summary in-game.Quick ThoughtsNotes/Comments/Questions:Feel free to tell us a little about yourself, why you are looking for mental skills training, or anything else!Privacy & ConsentConsent* I agree to the privacy policy and consent.I hereby give my permission to GameSync Esports Centers & Gaming, LLC and all staff, partners, contractors (hereby referred to as "Mental Skills Trainer") to allow them to apply their knowledge of theories, research, and mental skills training from Sport and Performance Enhancement Psychology in sessions together. This may include: 1. Teaching participants specific performance enhancement skills for application in sport, exercise, and other contexts. Examples of techniques include relaxation, concentration, imagery, positive self-talk, and centering. 2. Within performance settings, helping participants understand, measure, and improve elements of their performance through strategies such as goal setting, etc. 3. Educating teams, organizations and groups on topics such as communication, leadership and team cohesion. It is understood that the Mental Skills Trainer will keep all sessions confidential, but in the event the client is to potentially cause harm to oneself or another, or there are signs of abuse (e.g., child abuse, elder abuse), mandated reporter laws require that the Mental Skills Trainer break confidentiality by informing the appropriate authorities. In addition, if the Mental Skills Trainer suspects habitual substance abuse, this may be grounds to break confidentiality. In the event something arises that is outside the Mental Skills Trainer's scope of practice, a referral will be made to the client to see the a psychologist, counselor (or similar outside resource), or if not at a school site, to an outside professional referral. When working with minors, the Mental Skills Trainer may also encourage the client to share with his/her parents or guardian that they have been referred to another professional resource; and, in some instances the Mental Skills Trainer may also break confidentiality and tell the parent/guardian about a referral if the Mental Skills Trainer feels this is appropriate (i.e., in the best interest of the client). As of now, GameSync and the Mental Skills Trainer are offering these sessions completely free of charge ($195 value). As such, the client may be asked to provide a testimonial on the benefits gained from the sessions. This may be either via survey, email, or other means. Additionally, all Zoom sessions will be recorded and able to be viewed by the Mental Skills Trainer and GameSync staff to be used for promotional material development. Unless explicit permission is given by the client, the information in the recordings will not be used in a way that breaks client confidentiality.Cancellation* I agree to the cancellation policy.We understand that sometimes a client is unable to make a scheduled appointment due to unforeseen circumstances. However, we require that you reschedule or cancel appointments within 24 hours of a scheduled session. If you are a no-show or fail to reschedule/cancel an appointment without giving the 24 hours notice, a $60.00 USD charge will be applied to the card on file for each missed appointment. We are sure you are aware that missing an appointment prevents us from offering the services you deserve. However, it is also detrimental to us because it prevents us from scheduling another who needs services as well. Thank you very much for your kind understanding.