2019 Summer BootCamp
Online Registration & Waiver - General Information

PLEASE COMPLETE ONE REGISTRATION PER INDIVIDUAL.
General Information
First Name *
Your answer
Last Name *
Your answer
Address *
Your answer
City *
Your answer
State *
Your answer
Zip *
Your answer
Primary Phone *
(XXX) XXX-XXXX
Your answer
Email *
Your answer
Package Pricing
Session 1 Packages: June 3rd - July 4th (5 Weeks)
- 2 days/week (10 Sessions) — $100 (Early Bird Pricing $90)
- 3 days/week (15 Sessions) —$110 (Early Bird Pricing $100)
- 4 days/week (20 Sessions) —$115 (Early Bird Pricing $105)

Session 2: July 8th - August 8th (5 Weeks)
- 2 days/week (10 Sessions) — $100 (Early Bird Pricing $90)
- 3 days/week (15 Sessions) —$110 (Early Bird Pricing $100)
- 4 days/week (20 Sessions) —$115 (Early Bird Pricing $105)

​***Early Bird Pricing (Register & Pay before 5/24/19)***

Registration must be completed and Payment received before 11:59 PM on 5/24/19 for early bird pricing to apply. The discount can be applied to each session you purchase (e.g., if you Register + Pay for the Session 1 package AND a Session 2 package before 5/24/19, your total discount would be $20). 
Select your Session!
Make your selection below. *
2 days/wk
3 days/wk
4 days/wk
N/A
Sess. 1 (6/3-7/4)
Sess. 2 (7/8-8/8)
Emergency Contact Information
Emergency Contact Name *
Your answer
Emergency Contact Phone *
(XXX) XXX-XXXX
Your answer
Emergency Contact Relationship *
Your answer
Health History
Please rate your physical condition
(with 10 being the best)
Age
Your answer
Please indicate any injuries, medications, or other pertinent health information that may affect your ability to participate.
Your answer
T-Shirts
If you would like a 2018 Summer BootCamp shirt please indicate Size, Style (Tank-top or T-Shirt), and Quantity below for each shirt you would like to purchase. $20 ea. *
Your answer
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