Boot Camp Re-Enlistment Form & Release

In order to use this form, each statement below must be true. Please check each box to confirm your agreement.

I have attended an Austin Boot Camp For Men within the past six (6) months.

I confirm that my personal contact information has not changed from my original registration.

I confirm that my emergency contact, medical history, and medical status have not changed.

Should any of these statements be untrue, then you will need to fill out a new registration form; otherwise, your original agreements on file are still binding.

First and last name:

E-mail address:

Confirm e-mail:

Home phone:

Mobile phone:

Men's camp location & date:

SW = SouthWest CENT = Central Austin RR = Round Rock
BC = Bee Cave RR = Round Rock PF = PFlugerville

Number of days
per week:

If purchasing individual classes, how many?

I rate my current
fitness level as a:

(1-10), 10 being high

Are you training for an event, such as a race, reunion, wedding, etc?

If so, what?

When?

Do you know anyone that would be interested in our boot camp program?

Name:

Phone: Email address:

Comments:

RELEASE

This release is entered into between the undersigned and Austin Boot Camp For Men. The purpose of Austin Boot Camp For Men is to provide fitness instruction and coaching for various levels of athletes/individuals.

The undersigned hereby acknowledge that the following was explained to me and/or agree to the following:

Acknowledges that Craig Johnston, Stephanie McDonald, and the Austin Boot Camp For Men Coaches are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.
Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that Austin Boot Camp For Men does not guarantee neither good nor bad will occur nor guarantees the training advice given by Austin Boot Camp For Men will produce good nor bad results.
Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician at once.
Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the inherent dangers of the natural elements, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop. The undersigned expressly waive, release, discharge and agree not to sue from any liability of death, disability, personal injury, or action of any kind and Austin Boot Camp For Men for the undersigned participating in said sporting events and/or training for said sporting events.

The Undersigned agrees that this is the full agreement between the parties, that Austin Boot Camp For Men, nor anyone else has not verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement free and voluntarily without force or coercion.

Check the following:

I will remember to set my alarm and be at camp on time.

I agree that I will not consume alcohol during the month of Boot Camp. Any violation will result in twenty push-ups per occurrence.

I agree not to use foul language during Boot Camp. Any violation will result in twenty push-ups per occurrence.

I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation will result in twenty push-ups per occurrence.

I understand that photos or video may be taken during the course of my involvement in Boot Camp, which may be used for promotional purposes. I understand that my "before & after" photos will not be used for any promotional purposes unless I give written authorization.

I understand there is no refund policy.

Your signature will be required at the time of your evaluation, and you agree to the terms now!

PAYMENT

NOTE: Your registration will be confirmed only after receipt of payment. Space is limited, so please submit your payment immediately. There will be a $5 late fee incurred for each day past the first day of camp that your payment is late.

Please select your payment method:

Using a coupon.* Amount: Coupon source:
*Please review the NOTE below regarding payment and coupon processing.

Using a gift certificate.* Amount: Gift cert number (if available):

Gift cert source: Specifics:
*Please review the NOTE below regarding payment and gift cert processing.

        NOTE: If paying by credit card, coupon and gift certificate amount will be manually refunded
        after completion of payment. If paying by check, please deduct the coupon or gift certificate
        amount from the registration fee. Restrictions apply. Limit one coupon or gift certificate
        per person. May NOT be combined with any other offer. Please submit your coupon
        or gift certificate with your payment or to your coach.

Paying online with credit card.

        Name* on credit card or PayPal account:
        NOTE: *Name is required so that we can match your registration form to your payment. After
        submitting your registration form, you will be directed to the boot camp payment page where
        you must select the appropriate camp format. All credit card payments will be processed         through PayPal. No PayPal account required.

Mailing check.

        Name* on check:   Check Num:
        NOTE: *Name is required so that we can match your registration form to your payment. After
        submitting your registration form, you will be directed to the boot camp payment page where
        you must select the appropriate camp format. Checks should be mailed no later than 7
        days prior to the start of camp. Otherwise, bring your payment to camp and give to
        your coach.

By submitting this form, you are agreeing to the terms above!

Austin Boot Camp For Men • www.AustinBootCampForMen.com • Austin, Texas
For more information call 512-909-3143 or write to info@austinbootcampformen.com
© Copyright 2008 Austin Boot Camp For Men. All Rights Reserved.