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Gift Certificate Registration

What a wonderful gift to give! 
The lucky recipient of your gift will not only lose inches, but she will feel more energetic and have a new zest for life!

To purchase your gift certificate and secure a spot, please fill out the Secure online form below.

(If you would like to send a check, please print this form and send to the address below.)
 *We cannot guarantee your space will be reserved if you do not supply us with payment information on this form if sending via internet.

If paying by check, please make check out to: Brea ABC   
Mailing address:  
Adventure Boot Camp
2826 E. Imperial Hwy.
Brea, CA 92821

Camper's Name 
(of gift certificate recipient):
Camper's Address:
Camper's City
Camper's State
Camper's ZIP
Name of person purchasing
GIFT CERTIFICATE:

The gift certificate will indicate it is from YOU.  Please type your name above..

Your mailing address 
(the gift giver):

The gift certificate is normally mailed to you so you may present the gift to the person you are purchasing it for.  However, IF you would like the certificate sent to the recipient-camper, please type "Send to Camper," in the box above and we will be happy to do so!
Your City
Your State
Your ZIP
Phone# of Camper-Recipient:        Phone# of Gift Giver (you):   
Please program and price: 
Recipient-Camper will be able to choose her desired date of camp session, camp location and camp time.
Please Click Here to view our Calendar for upcoming camp dates, locations and times.
Are you adding Nutrition 101? Yes No     What is Nutrition 101?

Nutrition 101:  
(Your results will triple if you are eating healthy, well balanced meals throughout the 4-week camp)
 Form of payment:    
For security reasons, your credit card information is not stored or saved within our system. Your credit card information is required at this time to process your registration. PLEASE verify all credit card numbers are entered before sending.
*Receipt of payment will be sent to your email address
Credit Card Number:

no spaces   

 Exp. Date:    /  
Name on Credit Card:

 

 CVC Code*:   (security code)
*Visa and MasterCard
In the signature box on the back of your Visa you should see a 16-digit credit card number followed by a special 3 digit code. This 3 digit code is your CVC.

American Express
On the front of your card next to your main credit card number look for a 4 digit code. This 4 digit number is the Card Security Code.

 

I agree to all Terms and Conditions listed above
 
 

 
For More Information, Contact us at (714) 455-2110 or e-mail Suzanne@BreaBootCamp.com
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