To register for an upcoming Phoenix Adventure Boot Camp just follow the simple instructions below.

 

If paying by credit card or e-check Click Here:

If paying by check or money order:

1. Click Here to print the registration form, agreement, medical history, and release form.

2. Complete the registration form - please print clearly. Make checks payable to: Phoenix Adventure Boot Camp.

3. Mail the registration form and payment to:

Phoenix Adventure Boot Camp
PMB #515
5555 N. 7th St. Ste. 134
Phoenix, Arizona 85014

4. When we receive the registration and payment, we will contact you via phone or email to schedule you.

Phoenix Adventure Boot Camp Registration

Name: ______________________________

Street: ______________________________

City: __________________________ State: _________
Zip Code: _________

Profession: ______________________________

Date of Birth: ___________________________

Emergency Contact Name: ________________________

Phone #: ______________

Home Phone: (______)______________

Work Phone: (______)_______________

Fax#: (______)____________________

E-Mail: _____________________________________

 

Please choose your program (check one):

Option #1 _______

3 days a week for 4 weeks $199.00

Option#2________

5 days a week for 4 weeks $240.00 (no Monday classes).

 

Please choose your camp (check one):

Winter Boot Camp 2 (April 8 - May 2) _________

Summer Boot Camp (May 6 - May 30) _________

 

Payment method (check one):

Check/Money Order ___________

Paypal (credit card/e-check) _________

Name on Paypal account (if different from registration name above):

_______________________________________

 

Phoenix Adventure Boot Camp Agreement

1. I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or preapproved with Boot Camp directors.

2. I understand there is no refund policy, but I can receive a credit (for the unused portion of the camp) towards a future camp if I’m not able to complete the one I originally joined. Camp fees cannot be used towards any other products or services.

3. 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.

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

5. I will remember to set my alarm and be at camp ON TIME!

_______________________
Signature

________________________
Printed Name

________________________
Date

 

RELEASE FORM

This release is entered into between the Undersigned and Phoenix Adventure Boot Camp, Inc., its officers, affiliates and executors in addition to the City of Phoenix, and the county of Maricopa.

The purpose of Phoenix Adventure Boot Camp, Inc. is to provide fitness instruction and coaching for various levels of athletes/individuals.

Note: We reserve the right to refuse the participation in camp, if the instructor feels that the safety of the group or individual would be in jeopardy.

The Undersigned hereby acknowledges that the following was explained to me and/or agree to the following:

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

2. Acknowledges that Phoenix Adventure Boot Camp, Inc. instructors, support staff, and affiliates are not physicians and is not trained in any way to provide medical diagnosis or any other type of medical advice.

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

4. 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.

5.. Acknowledges that boot camps, aerobic classes, martial arts, kick-boxing, kung-fu, running, weight training, obstacle courses, and any other related sports/activities 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 for participating in these types of events/activities, 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 Phoenix Adventure Boot Camp, Inc., Tammy Kaatz for the undersigned participating in said activities or events and/or training for said activities or events.

The Undersigned agrees that this is the full agreement between the parties, that Tammy Kaatz 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.

____________________________
Signature
____________________________
Printed Name
____________________________
Date

 

Medical History

1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc)?
Yes - No If Yes, please list: ____________________________________
2. Do you take any prescribed medication on a permanent or regular basis? Yes - No If Yes, please list: _____________________________
3. Do you have a seizure disorder (epilepsy)? Yes - No
4. Do you have diabetes (adult or juvenile)? Yes - No
5. Have you ever been found to be anemic (low blood count)? Yes - No
6. Do you have High Blood Pressure (hypertension)? Yes - No
7. Do you have or have you ever had the following diseases?
Heart Disease: Yes - No ------ Lung Disease: Yes - No
Kidney Disease: Yes - No -----Liver Disease: Yes - No
8. Do you have asthma? Yes - No
9. Have you ever had a severe neck injury? Yes - No
10. Have you ever been knocked unconscious? Yes - No
11. Do you wear glasses or contact lenses? Yes - No
12. Have you had a broken bone or fracture in the past 2 years? Yes - No
If Yes, please describe: ________________________________________
13. Have you ever injured your back? Yes - No
If Yes, please describe: ________________________________________
14. Do you currently have back pain? Never - Seldom - Occasionally - Frequently with vigorous exercise or lifting
15. Have you had knee pain in the past 2 years that has disabled you for longer than a week? Yes - No
If Yes, please describe: _________________________________________________
16. Do you have any other physical conditions which cause pain? Yes - No
If Yes, please describe: _________________________________________________

17. Please describe any surgeries you’ve had: ______________________________________________
18. On a scale of 1 to 10, rate your current fitness level (10 being the highest fitness level): _______
19. Are you training for a specific event: Yes - No
If Yes, please describe: __________________________________________________

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

_________________________
Signature
_________________________
Printed Name
_________________________
Date

Mail or fax completed forms to:

Phoenix Adventure Boot Camp
PMB #515
5555 N. 7th St. Ste. 134
Phoenix, Arizona 85014

Phone: 602-274-1170
Fax: 480-275-3705