Atlanta Adventure Boot Camp

Secure Atlanta Adventure Boot Camp Re-Enlistment Form

Thank you for re-registering in Atlanta Adventure Boot Camp!

PAYMENT INSTRUCTIONS:

If you are paying by credit card, you will automatically be redirected to the online payment page to complete your payment process.
If you are paying by check or money order, please, only submit your application. DO NOT complete the Online Payment Form.
Since it is only a 4-week class, we do prefer you to attend the full 5-day a week program
for best results and overall work-out! You can do it!!!
Your registration will be confirmed only after receipt of payment.
Spaces are very limited, so please submit your payment immediately.

Check or money order made out to:
Atlanta Adventure Boot Camp
P.O. Box 1972
Tucker, GA 30085

Step 1

Please fill in the re-enlistment form clearly and completely.

I have attended an Atlanta Adventure Boot Camp within the past six 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.
PERSONAL INFORMATION:
First Name:
Last Name:
email Address:
Phone:
Date of Birth :	Month: Day: Year:
Which Camp are you signing up for Choose Time:
How many days/week?	5 day/week ~~$299~~ $267 4 day/week ~~$249~~ $227 3 day/week ~~$199~~ $177 Note: If credit or debit card is your only option, you can pay the full amount and expect the discount refunded back to you or you can send check or money order to above address. Thanks!
Camp frequency and cost?
EMERGENCY CONTACT:
Name:
Phone:

I rate my current fitness level as a:		(1-10, ten being high)
Should any of these statements be untrue, then you will need to fill out a new registration otherwise, your original agreements on file are still binding.
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 Atlanta Adventure Boot Camp, its officers, affiliates, and executors in addition to the City of Atlanta, any and all other private and public locations for camps and the county of Gwinnett. The purpose of Atlanta Adventure Boot Camp is to provide fitness instruction and coaching to various levels of athletes/individuals. The undersigned hereby acknowledge that the following was explained to me and/or agree to the following: 1. Acknowledge that Atlanta Adventure Boot Camp 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 Atlanta Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Atlanta Adventure Boot Camp will produce good nor bad results. Unusual changes during or following an exercise session may occur. These may include muscular or joint injury, abnormal blood pressure, fainting, disorders of heart beat, and/or very rare instances of heart attack or death. 3. I Acknowledge that the undersigned has been advised if they feel tired, feel pain, or feel out of the ordinary in any way (whether related to training or otherwise), that the undersigned should contact a physician at ounce. 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 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 Atlanta Adventure Boot Camp LLC 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 Atlanta Adventure Boot Camp, LLC 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. All members MUST adhere to the following: I agree that I will not consume alchohol 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 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 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, but I can receive a credit (for unused portion of camp) towards a future camp 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 Atlanta Adventure Boot Camp. I will remember to set my alarm and be at camp on TIME. Your signature will be required at the time of your evaluation and you agree to the terms now! ____________________ Signature (only if printed and mailed) ____________________ Printed Name (only if printed and mailed) ____________________ Date (only if printed and mailed)

I agree
Comments:

Step 2

3 days $199.00	4 days $249.00	5 days $299.00

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