* Required fields
Name *
E-mail Address *
Contact Phone 000-000-0000 *
Street Address: *
City *
State *
Zip Code *
Date of Birth 00/00/0000 *
Profession: *
Where did you hear about us: *
Please rate your current fitness level: (Ten is highest) *
This is my first camp: *	Yes No
If you answered "no" where and when was the last camp?
Camp date registering for: *
Special Code:
Camp Days per week *
Camp Time *
Emergency Contact: Name and Phone # : *
	MEDICAL HISTORY QUESTIONS
1. Are you allergic to any medication, food or bug bites? Please list: *
2. Do you take any prescribed medication (permanent/semi-permanent)? Please list: *
3. Do you have diabetes? *	Yes No
If yes to above, please list medications
4. Do you have a seizure disorder (epilepsy)? *	Yes No
If yes to above, please list medications
5. Do you have Asthma? *	Yes No
If yes to above, please list medications
6. Do you have High Blood Pressure (hypertension)? *	Yes No
If yes to above, please list medications
7. Do you have or have you ever had the following diseases? *	Heart Disease Lung Disease Kidney Disease Liver Disease
8. Have you ever been found to be anemic (low blood count)? *	Yes No
9. Have you ever had a sever neck injury? If Yes, please describe:
10. Have you ever been knocked out? Please describe.
11. Have you had a broken bone or fracture in the past 2 years? Please describe:
12. Have you ever injured your back? Please describe.
13. Do you have back pain? *	Never Seldom Occasionally Frequently Only with vigorous exercise or heavy lifting
14. Have you had knee pain in the past 2 years that has disabled you for longer than a week? Please describe:
15. Do you have other physical conditions which cause you pain? Please describe:
16. Please note any surgical procedures:
17. Please tell us about your Goals you'd like to accomplish for TA Boot Camp: *
18. Do you wear contact lenses or glasses *	Yes No
19. What is your hat size? *
20. What is your T-shirt size? *
	Click here if you've read and agree to all terms and conditions of the release below: Dont submit til you read release below. *

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RELEASE:

This release is entered into between the registering party and Soul Personal Training/True American Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the City of Aurora and Centennial, Colorado, Cherry Creek School District, Cherry Creek State Park and the County of Arapahoe. The purpose of Soul Personal Training/TA Boot Camp is to provide fitness instruction and coaching for various levels of athletes & individuals. The registering party hereby acknowledges that the following was explained to me and/or I agree to the following:

1. Acknowledges that Intructor of Soul Personal Training / True American Boot Camp 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 Soul Personal Training/True American Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Soul Personal Training/True American Boot Camp will produce good nor bad results.

3. Acknowledges that the registering party 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 registering party 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 registering party expressly waives, releases, discharges and agrees not to sue from any liability of death, disability, personal injury, or action of any kind Soul Personal Training/True American Boot Camp. for the undersigned participating in said sporting events and/or training for said sporting events.

5. Acknowledges that the registering party is in good health and is able to participate in Boot Camp. (Please call if you have any questions before proceeding.)

The registering party agrees that this is the full agreement between the parties, that Soul Personal Training/ True American 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 agree to show up for True American Boot Camp every day unless it is an excused absence from my doctor or approved by my Boot Camp director.

I understand there is NO REFUND policy, but I can receive a credit (for the unused portion of the camp when the instructor has been given 24 hours notice) towards a future camp if I’m not able to complete the one I originally joined. True American Boot Camp fees cannot be used towards any other products or services.

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 and after” photos will not be used for any promotional purposes without my express written consent.

I understand that diet and nutrition will effect my fitness goals and performance during boot camp.

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

By checking the box to agree to all terms and conditions, I expressly waive, release, discharge, and relinquish Soul Personal Training/True American Boot Camp from any and all causes of action, including any liability of death, disability, personal injury, or action of any kind, that may arise out of my participation in Soul Personal Trainig/True American Boot Camp. activities or events and/or training for such activities or events.