Registration Form

1. Are you allergic to any medications (aspirin, penicilin, sulfa, etc.).	Yes No If yes, please list:
2. Do you take any prescribed medication on a permanent or semi-permanent basis?	Yes No If Yes, please list:
3. Do you have a seizure disorder (epilepsy)?	Yes No
4. Do you have diabetes: Type I (IDDM) or Type II (NIDM)?	Yes No
5. Have you ever been found to be anemic (low blood count)?	Yes No
6. Do you have High Blood Pressure (Hypertension)?	Yes No
7. Do you have or have you ever had Heart Disease?	Yes No
8. Do you have or have you ever had Lung Disease?	Yes No
9. Do have or have you ever had Kidney Disease?	Yes No
10. Do you have or have you ever had Liver Disease?	Yes No
11. Do you have or have you ever had asthma?	Yes No
12. Do you have or have you ever had severe neck injury?	Yes No
13. Have you ever been knocked out?	Yes No
14. Have you had a broken bone or fracture in the past 2 years?	Yes No
15. Do you wear glasses or contact lenses?	Yes No
16. Have you ever injured your back?	Yes No
17. Do you have back pain?	Yes No If yes, please explain:
18. Do you have other physical conditions, which cause you pain? Please explain:
19. Have you had any surgical procedures? Please explain:
20. Have you had knee pain in the past 2 years that has disabled you for longer than a week?	Yes No
21. Have you ever had your body fat tested?	Yes No
22. Are you training for a specific event?	Yes No
23. What are your goals for the next 3 months?
24. First time participants will receive a free T-shirt. What is you T-shirt size?
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 Frisco Adventure Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the City of Frisco. The purpose of Frisco 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 Linda Sabin and any employee of Linda Sabin 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 Frisco Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Linda Sabin including Frisco 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, kickboxing, 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 Frisco 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 Frisco Adventure Boot Camp including Linda Sabin 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. Customer client agrees to confidentiality with respect to Frisco Adventure Boot Camp and all services provided by same. The undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of Frisco Adventure Boot Camp. The undersigned agrees to a non-compete within a 50 mile radius of Frisco for a period of 5 years from date of participation. Yes, by checking this box, I agree to the terms above.
PERFORMANCE PLEDGE In the spirit of harnessing your best effort and providing optimum results from your Boot Camp experience, we have established the following policies you will need to adhere. I agree not to use foul language during Boot Camp. I agree not to say the words Twinkie, Donuts, Ho-Ho's or Ding Dong during the course of Boot Camp. I agree to show up every day unless it is an excused absence or pre-approved by the Camp Director. I will arrive at Boot Camp ON TIME. (Any violation of the above statements will result in twenty push-ups per occurrence) 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, but I can receive a credit (for unused portion of camp) towards a future camp if I'm not able to complete the one I originally joined. Camp fees cannot be used towards any other products or services provided byby Frisco Adventure Boot Camp. I will remember to set my alarm and be at camp on time. I understand that diet and nutrition will effect my fitness goals and performance during boot camp. I will bring a positive attitude, and expect to have fun! Yes, by checking this box I agree to the terms above.
Electronic Signature:
DATE: (MM/DD/YEAR)
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