Name

Age

Addresss

Postcode

Tel No.

Email address

Do you suffer with any of the following?
Heart disease, diabetes, angina, high or low blood pressure, high cholesterol, lung disease, stroke or heart attacks.
Yes      No

If you have answered yes to the above you will need a doctors note stating you are fit to perform exercise. Please bring this with you to boot camp.

Do you suffer with asthma?
Yes      No

Are you pregnant or post natal? (within 3 months)
Yes      No

If you are pregnant you will require a doctors note. If postnatal you must have had your final post natal check up and ok before attending boot camp.

Are you currently taking any prescribed medication?
Yes      No
If yes please list

Have you recently had any surgery or physiotherapy treatment within the last 3 months?
Yes      No
If yes please list

Are you currently training or partaking in exercise/sport?
Yes      No
If yes please state

Have you attended a boot camp before?
Yes      No

Is there any reason on this form why you should not follow any activity program?
Yes      No
If yes please state

LEGAL DISCLAIMER - I would like to take part voluntarily in a No Inch to Pinch Boot Camp in an attempt to improve my fitness and help me lose weight. I understand the programme will include outdoor/indoor activities and is designed to minimise any possible risks and help improve my cardio vascular fitness, muscle strength, endurance and flexibility based on the information i have given. The program will include a warm up, exercising at a rates of perceived exertion/effort and a cool down.In order for the program to remain effective it will progress and change according to your fitness/strength levels and abilities at that time. Any exercise program carries with it an element of risk through improper use of advice given and equipment used. Your program will be fully explained and demonstrated for you. If you have any doubts or questions please ask for an explanation or clarification. I declare that the information given is correct and I agree to inform the organisers of the Boot camp of any change in my health and that I am responsible for monitoring my condition throughout the exercise program. Also in consideration for me being allowed to participate in the boot camp I will Assume the risk of all parts of the program and further agree to the extent permitted by the law to hold the organisers/instructors and owners of Willclare Sports Centre from any claims that may result in injury or death accidental or otherwise, arising from the Boot camp program. By ticking 'I AGREE' I have read and understood this form in it’s entirety and that any questions that I may have will be answered in full prior to the program starting.

Refund policy.
In the event of a cancellation prior to your boot camp start date there will be NO REFUND unless a doctors note is produced. In such an event you will be given a 50% refund of your course fee.
During boot camp course there will be no refund given unless a doctors note is produced. In such an event you will be charged on attended sessions at 12.00 per session. Doctors note must cover all dates of absence.

Please note: Please wear suitable attire and footwear based on outdoor and indoor training. We accept no liability for incorrect attire and footwear being worn and for any damages or loss of personal items.
I AGREE

Choose Bootcamp Dates: WINTER OFFER - PAY FOR OCTOBER AND GET NOVEMBER FREE