Adventure Boot Camp for Women - Anaheim Hills,Yorba Linda, Viklla park, Orange, Placentia, also serving Tustin, corona, North Orange County, CA.

Women's Fitness Camp in Anaheim Hills, Yorba Linda, Villa Park/Orange/ Placentia, Maui, Hawaii.

ANAHEIM HILLS ADVENTURE BOOT CAMP REGISTRATION FORM

You now have 2 options:
A. You can click here to print this form and send it in with payment by mail, or
B. Fill out this online form to register "secure" immediately via internet.

NOTE: We cannot guarantee your space will be reserved if you do not supply us with payment information on this form if sending via internet.

If paying by check, please make check out to: Anaheim Hills Boot Camp
Mailing address:
8018 E. Santa Ana Canyon, Suite 100-156
Anaheim Hills, CA 92808

You will be notified to schedule your pre-camp evaluation (if needed for your program). If first camp, please fill out ENTIRE form.

Name

Today's date

Mailing Address (MUST match credit card)

City

State

ZIP

GIFT CERTIFICATE #

Discount? Please explain briefly.

Physical address if different from above

Profession

Date of Birth

(mm/dd/yyyy)

Phone Number

Work Number

Cellular Number

Email Address (VERY important! You
will receive Boot Camp information here.)

I rate my current fitness level as a (1-10), ten being high.

I was referred by/How did you hear about us?

This is my first camp: Yes No

If you answered "no", when was the last camp you attended:

Name of Emergency Contact & Phone Number

ALL CLASSES ARE 3, 4 or 5 DAYS A WEEK.

**Sign up for the last 4 camps & save 15%!!! You must be one of the first 15 to receive this special one of a kind offer!

Anaheim Hills & Villa park Boot Camps

Which time are you signing up for?

Which dates are you signing up for?

Please select days and price:

Form of payment:

Note: If paying by check, please print this online form and mail or fax it in with payment. *Please note - we cannot guarantee your reserved spot until payment is received.

For security reasons, your credit card information is not stored or saved within our system. Your credit card information is required at this time to process your registration. PLEASE verify all credit card numbers are entered before sending.

Credit Card Number:	no spaces	Exp. Date:	/
Name on Credit Card:		*CVC Code:**	(security code)

*Visa and MasterCard
In the signature box on the back of your Visa you should see a 16-digit credit card number followed by a special 3 digit code. This 3 digit code is your CVC.

American Express
On the front of your card next to your main credit card number look for a 4 digit code. This 4 digit number is the Card Security Code.

If paying by check, please make payable to Anaheim Hills ABC.
8018 E. Santa Ana Canyon, Suite 100-156
Anaheim Hills, CA 92808

Waiver must be signed below prior to participation.

*Do you have any pain, previous surgeries, medication, injuries, etc. that may affect your running or should concern us? Please describe all of them below:

My main goal is:

Comments:

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 Anaheim Hills Adventure Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the Anaheim Hills Township. The purpose of Anaheim Hills Adventure Boot Camp is to provide fitness instruction and coaching for various levels of athletes/individuals.

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

1. Acknowledges that Jaime Hoben 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 Anaheim Hills Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Anaheim Hills 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 Anaheim Hills 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 Anaheim Hills Adventure 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.

Initial the following:

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. Camp fees cannot be used towards any other products or services provided by Anaheim Hills Adventure Boot Camp.
I will remember to set my alarm (or 2 alarms) and be at camp on time.
I understand that I may not switch between different camps. I must attend the time, date and city I have signed up for.
I agree to complete the full boot camp I am signing up for. There will be no quitting! If you have a pre-planned trip and know you will miss a couple days of camp, you MUST let your instructor know before you sign up in order to receive up to 2 days credit towards a future camp. We cannot credit towards injuries occurring out of camp.
And lastly, I will eat before I come to camp, and and I will also pay attention to my nutrition during camp because I know that my nutrition is 80% of my results!

By clicking on the SUBMIT button below, you agree to all of the terms above and acknowledge that you filled out this form with complete honesty. PLEASE TYPE FULL NAME BELOW - By typing your name below, you agree that this is your electronic signature agreeing to ALL of stated above.

I agree to all Terms and Conditions listed above

For More Information, Contact us at (714) 329-6718 or e-mail jaime@anaheimhillsbootcamp.com