Registration forms are now being accepted.  Hurry! Space is limited.  If you have additional questions, please send an email to info@sacbootcamp.com .

Sacbootcamp BOOT CAMP REGISTRATION You now have two options: 1. You can print this form and send it in by fax or mail, or 2. using our "SECURE", online form

If you chose option one, follow these instructions:

1. Print your information clearly or type
2. Fax to (916) 624-9088  or mail to:

Sacramento Area Adventure Fitness
PO BOX 1862, Rocklin, CA  95677

If you are paying by check, please make payable to
  "David Hay"

3. You will be notified to schedule your pre-camp evaluation.

YES, I’m ready for the Adventure Boot Camp.  Sign me up!   
  

Name
Street
City
State
Zip
Profession
Date of Birth
Emergency Contact
Emergency Phone
I'm signing up for the camp beginning on this date______/_______/______. The start time for my camp is ___ 5:30 AM ___9:00 AM This is my first camp ___ The last camp I attended was ________
Home Phone
Work Phone
Fax Number
Email
I rate my current fitness level as a _____ (1-10), ten being high.
I was Referred by
My goal is to
I will pay by : (circle one) Check Mastercard Visa American Express Discover
Credit cards will be charged:
Option #1	3 camp sessions per week for $145	_____
Option #2	3 camp sessions per week plus nutrition program for $197	_____
Other Camp	$12.00 per session (no nutrition program) $16.45 per session (with nutrition program)	_____
My card number is
Expiration	________ / ________
CCV	________
Name on card
Signature
If paying by check, please make payable to David Hay Sacramento Area Adventure Fitness PO BOX 1862, Rocklin, CA  95677 .  Confirmations and detailed instructions will be mailed prior to the start of Camp.  Waiver must be signed prior to participation.
MEDICAL HISTORY  (If you are a returning camper, only complete the sections that have changed.)
Yes No Questionnaire     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? List any medication     3. Do you have a seizure disorder (epilepsy)?     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 any medication Yes No 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 any medication     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?     Never    Seldom    Occasionally Frequently with vigorous exercise or heavy lifting     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 Sacramento Area Adventure Fitness, its officers and affiliates. The purpose of Sacramento Area Adventure Fitness is to provide fitness and exercise instruction and coaching for various levels of athletes/individuals.   The undersigned hereby acknowledges that the following was explained to them and/or agrees to the following:   1.       Acknowledges that the Sacramento Area Adventure Fitness owners and instructors are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, psychotherapy, or any other type of medical advice.   2.       Acknowledges that fitness training is another tool for teaching individuals about themselves, but that Sacramento Area Adventure Fitness and its owners do not guarantee neither good nor bad will occur nor guarantee the training advice given by the owners/instructors 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 their training, or otherwise, that the undersigned should contact a physician at once.   4.       Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, weight training, obstacle courses and any other related sports are an extreme test of one’s metal and physical limits and carries 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, 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 Sacramento Area Adventure Fitness for the undersigned participating in said sporting/fitness events and/or training for said sporting/fitness events.   5.       The Undersigned agrees that this is the full agreement between the parties, that Sacramento Area Adventure Fitness 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.     Please initial the following: ___ 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 agree not to use foul language during Boot Camp. Any violation will result in twenty push-ups per occurrence. ___ I agree that I will reduce my consumption of alcohol during the 4-week period.   ___ 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 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 cannot be used towards any other products or services provided by Sacramento Area Adventure Fitness. ___ I will remember to set my alarm and be at camp ON TIME.
Signature
Date