Brea Adventure Boot Camp Program Fitness Events in Brea Brea Boot Camp Brea Bootcamp History of Fitness Boot Camps Common Questions about Adventure Boot Camp Brea Fitness Boot Camp Bootcamp Photos

* RE-ENLISTEE *
BOOT CAMP
REGISTRATION
Name
(first - last)
Address
(match cc card)
City
ZIP
Home Phone Work Phone
Cell Phone  
Email Address
*Discount Code:     *Discount Name:   (If applicable)
One discount per session
Which location are you signing up for?    
Which program are you signing up for? 

Please select days and price: 
 
NOTE: 
Evening classes are Monday through Thursday only (no Fridays)


All MORNING  4-day campers, indicate your day off:   
All MORNING  3-day campers, select your days:
   
6:30 EVENING  3-day campers, select your days:   

Notes:

 
Form of payment: Cash or check payments must be received before camp fills to capacity or prior to expiration of special pricing discounts.
Credit Card Number:

no spaces   

Exp. Date:    /  
Name on Credit Card:

 

CVC Code*:   (security code)

MEDICAL HISTORY
*NO CHANGES SINCE LAST CAMP?  CLICK DROP-DOWN BOX BELOW and you may skip medical questionnaire..

 
I am a repeat boot camper and my medical information has not changed since last attending camp.

1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?
2. Do you take any prescribed medication on a permanent or semi-permanent basis?
3. Do you have diabetes? List Medications:
4. Do you have High Blood Pressure (hypertension)?
List Medications:
5. Do you have asthma?
List Medications:
6. Describe any severe injuries within the past 5 years or that may still cause pain:
7. Detail any surgical procedures:
8. Have you had your body fat tested?
If yes, what percent?
9. Are you training for a specific event?  If yes, explain:

NOTICE: It is wise to seek your doctors advice before beginning any health/fitness/nutrition program!

RELEASE
This release is entered into between the undersigned and Brea Adventure Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the Brea Township. The purpose of Brea Adventure Boot Camp 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:

1. Acknowledges that Suzanne Stringfellow is not a physician and is not trained in any way to provide medical
diagnosis, medical treatment, or any other type of medical advice.

2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that Brea Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Brea Adventure Boot Camp will produce good nor bad results.

3. 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.

4. 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 elements of a natural environment, 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 Brea Adventure Boot Camp 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 Brea Adventure Boot Camp 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.

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 and camp fees cannot be used towards any other products or services provided by Brea Adventure Boot Camp.

By clicking on the SUBMIT button below, you agree to all of the terms above and acknowledge that you filled out this form with complete honesty.

____________________
Signature
 ____________________
Printed Name
____________________
Date
 
*Note:  If you are unable to attend camp due to circumstances out of your control, we can offer you a refund if you notify us prior to your session start date; however, we will charge a $50.00 cancellation fee.  If we are notified after your session begins, we can only give you a credit towards another boot camp. This credit is nontransferable. There is no cash refund. This is not negotiable.

I agree to all Terms and Conditions listed above
 
 

 

For More Information, Contact us at (714) 455-2110 or e-mail Suzanne@BreaBootCamp.com
Program | Calendar | Registration | About Us | Our History | Common Questions | Photos | Contact Us | Testimonials | Home