In Nature Fitness

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    Personal Information

    Name

    Email

    Phone Number

    Address

    City

    Zip

    Profession

    Date of Birth


    Self Assessment & Additional Information

    I rate my current fitness level as: (1-10)

    Is this your first adventure boot camp:

    My Main goal is:

    I was referred by:

    How did you hear about us?

    Name of Emergency Contact

    Emergency Phone Number


    Medical History

    Enter N/A for any section which is Not Applicable for you.
    Are you allergic to any medication? List medications:

    Do you take any prescribed medication? List medications:

    Do you suffer from epilepsy? List medications:

    Are you anemic? List medications:

    Do you have Diabetes? List medications:

    Do you have High Blood Pressure? List medications:

    Do you wear glasses or contact lenses?

    Do you have Asthma?

    Do you have Heart Disease? List medications

    Do you have Lung Disease? List medications:

    Do you have Kidney Disease? List medications:

    Do you have Liver Disease? List medications:

    Have you ever had a severe neck injury? Describe:

    Have you ever been knocked out? Describe:

    Have you had a broken bone or fracture in the past 2 years? Describe:

    Have you had knee pain in the past 2 years that has disabled you for longer than a week? Describe:

    Have you ever injured your back? Describe:

    Describe any current pain you may be experiencing: Describe:

    Do you have other physical conditions which cause pain? Describe:

    Have you had any surgical procedures: Describe:

    What are your goals for the next three months? Describe:

    Have you had your body fat tested? Describe testing and results:

    Are you training for a specific event? If yes, explain:

    RELEASE
    This release is entered into between the undersigned and BABC/In Nature Fitness its officers, subsidiaries, affiliates, and executors in addition to the County of Bucks County Pa and Hunterdon County NJ. The purpose of Bucks Adventure Boot Camp/In Nature Fitness 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 the trainer's are not a physician's, nor 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 assisting athletes/individuals seeking to reach health/fitness goals, but that BABC/ In Nature Fitness does not guarantee results.

    3. Acknowledges that the undersigned has been instructed that if they feel tired, feel pain or feel unwell, in any way, to cease participating in class and seek medical attention from a physician.

    4. Acknowledges that live online training, boot camps, aerobic classes, martial arts, kick boxing, running, weight training, obstacle courses, and any other related training activities can be 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 trainings/events/activities including the elements of a natural environment. That the undersigned is fit, and that they have a regular medical physician that they can contact regarding any medical problems that 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 towards BABC LLC/In Nature Fitness/Megan Sullivan for the undersigned participating in said classes and/or training, via live online virtual training or in person.

    The Undersigned agrees that this is the full agreement between the parties, that BABC/ In Nature Fitness, it's trainers, have 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 BABC/In nature Fitness and all services provided by same. The undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of BABC/In Nature Fitness.
    One on one and small group clients, 24 hours' notice cancelation required so as not to forfeit session. Packages must be used within a time specified time frame. i.e. 10 sessions twice per week must be used in 5 weeks unless otherwise agreed upon.

    I agree not to use foul language or whine, any violation's will result in 10 Burpee's per occurrence! 🙂

    I agree not say the words Twinkie, Donuts, Ho-Ho's, Ding Dongs, or Cupcakes Any violation will result in twenty Burpee's per occurrence!

    I agree to show up for every class unless it is an excused absence from my doctor or pre-approved with Megan. Any violation will result in twenty push-ups 10 Burpee's & 20 Laps per occurrence!

    I understand that photos or video may be taken during the course of my involvement in this program, which may be used for promotional/inspirational purpose's and I give my consent for same. Testimonials/ media become the property of BABC LLC/In Nature Fitness to be used at their discretion.

    I understand there is a No Refund policy, though a credit may be issued for unused portion of program towards a future session at discretion of trainer. Program fees can not be used towards any other products or services provided by BABC/In Nature Fitness.

    I agree to be on time, prepared and ready to go by the time class begins.

    I understand that my daily nutrition affects my health/fitness goals,
    & attaining those goals.

    I will disclose on registration form, & discuss with Megan any illness,
    injury, physical limitations/restrictions prior
    to participating.

    I will bring a positive attitude!

    I agree to all Terms and Conditions

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