BOOT CAMP ON THE POINT: WINTER 2019 (Session 1)
Registration, Waiver and Release of Liability:
Please note: Only register if you are seriously planning to attend. In order to run the class I will need 8 participants. Please register by 1/13. Thanks so much!
You are registering for Winter Boot Camp, read the selections carefully. Please mark your calendars or take a picture of this form for your records. I am unable to pro-rate the session at this time, I apologize for any inconvenience.
Your name and address:
I am registering for:
Wednesday 6:00-7:00pm. ( NOT CURRENTLY RUNNING) Session dates: 1/16, 1/23, 1/30, 2/4, 2/13, 2/20. 6-week session.The cost of this session is: $60.00.
Saturday mornings 8:00am- 9:00am. Session dates: 1/19, 1/26, 2/2, 2/9, 2/16, 2/23. 6-week session. The cost of this session is $60.00.
BOTH Wednesday and Saturday sessions. Details listed above. Cost for both $115.00.
PLEASE NOTE: $15.00 walk-in fee with 24 hr. ADVANCE NOTICE. Text or email mkellett90@gmail or 585-507-8925. Prior registration still required. NO WALK-INS!!! Thank you.
Your date of birth:
Your cell phone number:
Emergency Contact Information:
Name and best number to reach them:
What is your current level of fitness:
How did you hear about Boot Camp on the Point?
Waiver and Release of Liabililty
I have agreed to participate in the Boot Camp on the Point, run by Michelle Kellett. I recognize that the program involves strenuous physical activity including, but not limited to, strength training, running, agility drills, jumping, intense cardiovascular activities and flexible training. I hereby affirm that I am in good physical condition and do not suffer from any known disability or condition which would prevent or limit my participation in this exercise program. I will notify Michelle Kellett of any such defects, in writing, prior to participation. I acknowledge that my registration and subsequent participation in this Boot Camp is voluntary. In consideration of my participation in this program, I hereby release and discharge Michelle Kellett from any claims, demands and causes of action as a result of my voluntary participation and registration in this Bootcamp. I hereby waive and release all rights to photography and video taken by or for Michelle during any boot camp or training program. Any photos or videos taken by or for Michelle are sole property of Michelle and can be used in any advertisements, marketing or publications used to promote Boot Camp on the Point or training with Michelle Kellett. Camp size is limited. Payment is due at time of registration. If you request a refund in writing within 24 hours of your registration, you will be entitled to a full refund. After the 24 hour grace period, all payments are non-refundable, and non-transferable. Payment by cash/check is due at the time of registration. By checking the box below, you agree to all terms listed in this agreement.
yes, I agree to the terms above.
Never submit passwords through Google Forms.
This content is neither created nor endorsed by Google.
Terms of Service