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Womens's Adventure Fitness Boot Camp in Rancho Santa Margarita, Orange County, California.

Adventure Fitness Trainer
Boot Camp
Register Now!
630-640-0467
Women's Fitness Camp in Fox Valley
Boot Camp Registration- Make Sure You go to the Payment Page
Enter The Biggest Loser Boot Camp Challlenge and Win $5000 in Cash and Prizes!

THE BIGGEST WINNER BOOT CAMP CHALLENGE REGISTRATION


Register O
nline
Fill out the online form below to register via internet. Click on Submit to go to the payment page.
Payment Page: Pay via Paypal , M/C, Visa, Amex. Choose your class and finish your online registration. A PayPal account is not required to pay via PayPal.

NOTE: Only 30 Teams will be allowed to compete and win $5,000 in cash and prizes!

1 to 1 Fitness Inc.
2642 Havens Dr
West Chicago IL, 60185
merlin@FVBootCamp.com
Phone: (630) 640-0467

Fill out the form below and Click on SUBMIT.
You must be 18 years of age or older to enter.
We are looking to spice things up just a bit by also featuring family members who want to lose weight together, including husband and wife teams, father and son teams, mother and daughter teams, and sibling teams.


You will be notified to schedule your pre-camp evaluation (if needed for your program).
Name
Address
City
City
Postal code
Profession
Why do you want to win?
Date of Birth (mm/dd/yyyy) Age
Phone Number Work Number
Fax Number  
Email Address
Team Mates Name
I rate my current fitness level as a (1-10), ten being high.
I was referred by:
How did you hear about us?:
Blast fax , friend , Ad
Please specify publication / website / friend ,key words searched or other referral:
This is my first camp: Yes | No If you answered "no", when was the last camp you attended:
My Main goal is:
Name of Emergency Contact & Phone Number
What is the name of the location you are joining and date? | Choose your event time/price from the 2nd pull down menu.
Form of payment:    

Biggest Winner Boot Camp Challenge Registrations Starting Aug 28 2008 A Deposit of $299+ TAX and 2 more payments of $250+ TAX 2 months apart

MEDICAL HISTORY  (If you are a returning camper, only complete the sections that have changed.)

1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?
List Medications:  
2. Do you take any prescribed medication on a permanent or semi-permanent basis?
List Medications:  
3. Do you have a seizure disorder (epilepsy)?
List Medications:  
4. Do you have diabetes Adult or Juvenile?
5. Have you ever been found to be anemic (low blood count)?
6. Do you have High Blood Pressure (hypertension)?
List Medications:  
7. Do you have or have you ever had the following diseases?
Heart Disease:
 
Lung Disease:  
Kidney Disease:  
Liver Disease:  
8. Do you have asthma?
List Medications:  
9. Have you ever had a severe neck injury?
 
Describe:
10. Have you ever been knocked out?
 
Describe:
11. Do you wear glasses or contact lenses?
12. Have you had a broken bone or fracture in the past 2 years?  
Describe:
13. Have you ever injured your back?  
Describe:
14. Do you have back pain?
15. Have you had knee pain in the past 2 years that has disabled you for longer than a week?
 
Describe:
16. Do you have other physical conditions which cause pain?  
Describe:
17. Detail any surgical procedures:
18. What are your goals for the next three months?
19. Have you had your body fat tested?
If yes, what percent is it?
20. 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 Adventure Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the Cities of Batavia,Geneva,St Charles and Wheaton. The purpose of Adventure Boot Camp is to provide fitness instruction and coaching for various levels of athletes/individuals. At all times you agree 100% that you take full responsibility for yourself and your safety.

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

1. Acknowledges that Merlin Hahn 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 Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Merlin Hahn including 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 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 Adventure Boot Camp including Merlin Hahn 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.

Customer client agrees to confidentiality with respect to Adventure Boot Camp and all services provided by same. The undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of Adventure Boot Camp.  The undersigned agrees to a non-compete within a 50 mile radius of Fox Valley Boot Camp for a period of  5 years from date of participation.

Checkmark the following:
I agree not to use foul language during Boot Camp. Any violation will result in ten push-ups per occurrence.

I agree to attend all the telephone Life coaching sessions.

I agree not eat or say the words Twinkie, Donuts, Ho-Ho's, Ding Dong, or Cup Cake during the course of 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 will be taken during the course of my involvement in The Biggest Winner Boot Camp challenge , which may be used for promotional purposes. I understand that my "before & after" photos will be used for any promotional purposes.

I understand there is no refund policy,all payments for the Biggest Winner Boot camp challenge must be made in full. Even if I decide to Quit, I can receive a credit (for unused portion of camp) towards a future camp. In addition any unused sessions become null and void after 90 days if I'm not able to complete the one I originally joined. Camp fees can not be used towards any other products or services provided by Merlin Hahn, Adventure Boot Camp.

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

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

I will bring a positive attitude, I won't gossip at camp, and expect to have fun

I agree to all Terms and Conditions listed above

Electronic Signature

Date (MM/DD/YYYY)

For More Information, Contact us at 630-640-0467 or e-mail merlin@FVBootCamp.com
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