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Fitness Boot Camp Registration Form

Fitness Boot Camp Payments  (right click this link & open in a new window)

Payment IN FULL & completion of this registration form will permanently hold your spot in the Fitness Boot Camp session you select.  If payment IN FULL is not received, your spot may be taken by another interested, paying individual.  You will not lose your spot to another interested, non-paying individual.  To permanently secure your spot in Fitness Boot Camp, click the link above to pay either a deposit or the full $235 (currenly $185).

* Required fields
Name *
E-mail Address *
Address *
City *
State *
Zip Code *
Phone Number *
Age *
Current Weight *
Current Height (in.) *
Boot Camp Session *
Location *
My Current Level of Activity *
Please List Current Medications *
Additional Necessary Notes for Corey... *
Please Select T-Shirt Size *

I have read and agree to the Privacy Policy *

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