Backcountry Fitness Athlete Registration Form
Welcome to Backcountry Fitness Bootcamps!
Here at Backcountry Fitness we have an amazing community and an instructor that will help you reach your specific goals.
Please fill out the registration form to the best of your knowledge, and if any illness or injury happens at class or while you are part of one of our programs please let your Trainer know immediately. If you are part of any of the online programs, contact me immediately if there are any health concerns or injuries that occur.

By filling out the questionare below you agree to the following:


Fitness Boot Camp Registration / Waiver Form


NOTICE: It is highly recommended that you seek your physician’s advice before beginning any new health/ fitness/nutrition program.

This release is entered into between the undersigned and Backcountry Fitness & Conditioning, its of cers, subsidiaries, affiliates , and executors in addition to the Province of Manitoba. The purpose Backcountry Fitness Boot Camp is to provide general fitness instruction and coaching for various levels of individuals.

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

1. Acknowledges that Christina Hopper 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 the undersigned has been told if they feel tired, feel pain, feel dizzy, or feel out of the ordinary in any way either related to exercise, or otherwise, that the undersigned should contact a physician at once.

3. Acknowledges that Backcountry Fitness boot camps, weight training, obstacle courses, running, and other related fitness activities are can be a 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 t, 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 Backcountry Fitness & Conditioning for the undersigned participating in said fitness activities.

The Undersigned agrees that this is the full agreement between the parties, that Backcountry Fitness and Conditioning, including Christina Hooper 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.

Customer client agrees to confidentiality with respect to Backcountry Fitness and Conditioning and all services provided by same. The undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of Backcountry Fitness and Conditioning.

⭐️By completing and submitting this form online you are agreeing and signing to the above information.
And you are confirming that indeed it is you/ the client who is filling out this registration form.
Christina Hooper

Backcountry Fitness & Conditioning
Box 264
Warren, MB
R0C 3E0

204-383-5284
204-899-8660

Inspiring lives, one body at a time


We are so excited to have you part of our fitness family and can't wait to see you reach your goals.

Name: *
Your answer
I have read the above waiver information and confirming that my information and answers are correct *
Required
Who Has inspired you to join bootcamp?(who referred you) *
Your answer
Date of Birth *
MM
/
DD
/
YYYY
Mailing Address: *
Your answer
Email Address: *
Your answer
Phone number *
Your answer
Emergency Contact Name & Number (Who should we contact if you become sick or injured ?) *
Your answer
Do you suffer from any of the following ? *
Required
If you answered yes to any of the above conditions please explain in full detail below: *
Your answer
What do you hope to Achieve in This Bootcamp session? *
Your answer
What is your main goal for health and fitness ? *
Your answer
Is there any other reason why you should not participate in any physical activity ? *
Your answer
Have you recently had an operation or illness? *
Are you taking any medications that your instructor should be aware of? *
Required
Have you been pregnant in the last 6 months? *
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