Women and Men's Adventure Fitness Boot Camp in Long Beach, bootcamp for women, adventure boot camp, co-ed fitness program, co-ed weight loss, exercise camp, co-ed camp, exercise, workout programs, outdoor exercise

Bootcamp Registration

Long Beach Adventure Boot Camp Class
REGISTRATION

You now have 2 options:
A. You can PRINT THIS FORM and send it in with payment (Make payment to Fitness Through Motion) by mail to:
Fitness Through Motion
Attn: Long Beach Adventure Boot Camp
P.O. Box 14351
Long Beach, CA 90853
info@LongBeachBootCamp.com
(562) 225-4181

B. Fill out the online form below to register online and then pay via PayPal.
Fill out the form below and click on SUBMIT ...
You will be taken to the payment page, where you can pay Via Paypal.

NOTE: We cannot guarantee your space will be reserved if you do not supply us with payment information on this form if sending via internet.

Once this form is complete and you have submitted payment, please register for your Pre-Evaluation
Click to set up your Pre/Post Evaluation time and day. No evaluations for Camp 4.

Registration Form
You will be notified to schedule your pre-camp evaluation (if needed for your program). Veterans (People who have taken class before), fill out top portion of registration only. Fill out Health History only if things have changed.
Personal Information
Name		Address
City		State / ZIP	/
Profession		Country
Date of Birth	(mm/dd/yyyy)	Phone Number
Work Number		Fax Number
Email Address		T-Shirt Size	(Men's sizes only-for comfort reasons)

Self Assessment & Additional Information
I rate my current fitness level as a (1-10), ten being high.
I was referred by:
How did you hear about us?:
Please specify publication / website / friend or other referral:
This is my first camp:	Yes \| No
If you answered "no", when was the last camp you attended:
My Main goal is:
Name of Emergency Contact & Phone Number	\|

Camp and Payment Information
Please choose these options carefully as you will be enrolled according to your choices.
What camp are you joining?
What time are you attending?
Choose your camp frequency and cost:
Form of payment:
If you are paying via PayPal, please provide your PayPal email address, so we can match your Registration with your Payment and confirm your spot.
PayPal Email Address:
CAMP OPTIONS: 4 Week Camp: 5 days a week - $299 4 Week Camp: 3 days a week - $199 6 Week Camp: 5 days a week - $448.50 6 Week Camp: 3 days a week - $298.50 Costa Rica Camp - Full Payment $2500 2 Week EXPRESS (M-F) $199 with instructors OK only 1 Week EXPRESS (M-F) $80 with instructors OK only Annual Membership: 5 days/week $2205 Annual Membership: 3 days/week $1470 6 Camp membership 5 days/week = $1435 6 Camp membership 3 days/week = $955 Ultimate Camp: 5 days = $399 Ultimate Camp: 3 days = $299 3 Day/week options are for people who have other commitments during the week. We prefer that you attend the full 5-day a week program for the best results and overall work-out! You can do it!

Medical History
(If you are a returning camper, only complete the sections that have changed.) I am a returning Vet and my health history has not changed
1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?
List Medications:
2. Do you take any prescribed medication on a permanent or semi-permanent basis?
List Medications:
3. Do you have a seizure disorder (epilepsy)?
4. Do you have diabetes Adult or Juvenile?
List Medications:
5. Have you ever been found to be anemic (low blood count)?
6. Do you have High Blood Pressure (hypertension)?
List Medications:
7. Do you have or have you ever had the following diseases?
Heart Disease:
Lung Disease:
Kidney Disease:
Liver Disease:
8. Do you have asthma?
List Medications:
9. Have you ever had a severe neck injury? Describe:
10. Have you ever been knocked out? Describe:
11. Do you wear glasses or contact lenses?
12. Have you had a broken bone or fracture in the past 2 years? Describe:
13. Have you ever injured your back? Describe:
14. Do you have back pain?
15. Have you had knee pain in the past 2 years that has disabled you for longer than a week? Describe:
16. Do you have other physical conditions which cause pain? Describe:
17. Detail any surgical procedures:
18. What are your goals for the next three months?
19. Have you had your body fat tested?
If yes, what percent is it?
20. Are you training for a specific event? If yes, explain:

Release
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 Fitness Through Motion, its officers, subsidiaries, affiliates, and executors in addition to the City of Long Beach and the Los Angeles County. The purpose of Ftiness Through Motion including Long Beach 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 Shannon Paul 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 Fitness Through Motion including Long Beach Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Fitness Through Motion including Long Beach 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, kick boxing, 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 Long Beach 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 Fitness Through Motion including Long Beach Adventure Boot Camp 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.
Checkmark the following:
	I agree not to use foul language during Boot Camp. Any violation will result in twenty push-ups per occurrence.
	I agree not eat or say the words Twinkie, Donuts, Ho-Ho's, Ding Dong, or Cup Cake during the course of Boot Camp. Any violation will result in twenty push-ups per occurrence.
	I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation 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 can not be used towards any other products or services provided by Fitness Through Motion including Long Beach 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!

Agreement and Signature

The Following Terms and Conditions are for Maui Boot Camp Participants only
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Find Your Balanced Body in Maui!
Terms and Conditions Agreement

1. PRICES, DEPOSIT and PAYMENT: Fares shown herein are per person, double occupancy in U.S. Dollars, and are subject to change without notice.
To hold your reservation: A non-refundable deposit is due at the time of booking in the amount set forth in the "Pricing" section of your tour. Your reservation is not guaranteed until this deposit is received in full. This deposit is applied towards your full payment.
Final payment must be received on or before specified date. Bookings may be cancelled by Fitness Through Motion if deposit or final payment is not received by due dates.
Payment may be made by cash, check, money order, or credit cards.

2. PRICE INCLUDES:
Trip manager: Your friendly knowledgeable tour manager/host accompanies you for the complete length of your vacation.

Flight: Round Trip airfare is included in the package.
Retreat accommodations are included and offer private facilities. Fitness Through Motion, Inc. selects only the best retreats available, without relinquishing value, comfort, convenience and scenic locations.
Meals: 3 meals/day are included in your vacation price. Alcoholic beverages are not included in the package.
Activities: Many activities such as hiking, snorkeling, surfing, kayaking, and luaus are included in the package.

Transportation: Island transportation to and from all scheduled events and activities.

A minimum number of participants is required to operate all escorted programs.
Personal expenses such as room service, phone calls, alcoholic beverages, and optional activities ARE NOT included.

3. RESERVATION CHANGES: A $100 per person service fee will be assessed for each change to a tour or air booking plus any additional fees that may be charged by our suppliers. Changes in departure date, itinerary or passenger are considered a cancellation and a new booking. All changes and substitutions are subject to space availability, rates and booking conditions in effect at the time of the change. No change will be made unless permitted under the terms of our cancellation policy even if you transfer to another departure.

4. REFUNDS: No refund or adjustment will be made in the event of interruption or cancellation of any individually arranged package after the final payment has been processed.

Fitness Through Motion, Inc. cannot be responsible for delays or changes in air or other services, sickness, weather, strikes or other factors beyond Fitness Through Motion, Inc.’s control. Should an additional overnight be required due to any of these causes, the hotel, meal and associated costs will be the passenger's responsibility. If conditions necessitate changes or certain features are unavailable or limited due to local or national holidays, we reserve the right to vary itineraries and substitute alternatives of a similar nature as available. If substitutes result in a lower cost, a refund will be made when you return home. No refund will be made for unused portions of the tour due to such factors or voluntary cancellations. Refunds are made on the basis of savings recovered from non-use of hotels, etc. No refund will be made for any unused group services. Refunds may not be available for services not taken unless the services omitted cover 48 consecutive hours or longer. No refund will be granted for missing sightseeing or meals etc.

5. TRAVEL AND HEALTH DOCUMENTS: Passport and visa requirements as well as vaccination certificates and other health requirements for travel between your home city and your tour destinations may change from time to time. It is the sole responsibility of the passenger to consult with the appropriate consulates to determine if any visas are needed and medical personnel to determine what health precautions and documents are necessary, and to obtain and have available when necessary the appropriate valid travel and health documents. Compliance with travel documents and customs regulations are the tour participant's responsibility. For non-US citizens a multiple entry visa will be required for some tour itineraries. Fitness Through Motion, Inc. accepts no responsibility for failure to notify travel participants of customs and immigrations laws or health requirements. Passengers who do not have proper documentation may be prevented from boarding a flight, without refund of the fare, and will be subject to any cancellation fees, fines or other costs, including those incurred by Fitness Through Motion that result from the lack of proper documentation.

6. ACTIVITY LEVELS: Our itineraries are active and are designed for different levels of fitness. Some trips may be more challenging than others (note activities in each day-by-day itinerary.)

7. HEALTH AND MEDICAL MATTERS: Each participant represents and warrants that he/she is physically and otherwise fit to travel on their chosen program.

8. MEMBERSHIP ON TOUR: Fitness Through Motion, Inc. reserves the right to accept, reject or not retain any person as a trip participant whose condition or general deportment impedes the operation of the tour or affects the rights or enjoyment of other passengers. A refund of unused tour services is the limit of Fitness Through Motion, Inc. liability if a person is required to leave the tour.

9. PHOTOGRAPHY: Fitness Through Motion, Inc. reserves the right to take photographs during any trip and to use these pictures as taken for promotional purposes. By booking with Fitness Through Motion, Inc., participants agree to allow their image to appear in such pictures. Participant who prefer that their image not be used are asked to notify the trip manager at the beginning of their tour.

10. LUGGAGE: No responsibility is accepted by Fitness Through Motion, Inc. for loss or damage to luggage or any other belongings while in custody of any airline, coach company or hotel. Travel insurance is strongly recommended.

11. CLOTHING: A suggested clothing list will be included with your documents. Comfortable, casual, layered clothing and running shoes are suggested.

12. Fitness Through Motion, Inc. reserves the right to alter itineraries should it become necessary or desirable. Other than major changes as below, Fitness Through Motion, Inc. reserves the right to make changes in routings, visits and tour timings at any time and guests will, if practical, be advised of any such changes before departure. Fitness Through Motion, Inc. is not obliged to advise guests or to pay them compensation. In the unlikely event that it is necessary for Fitness Through Motion, Inc. to cancel a tour or to make a major change (and a major change is a change to the departure date), Fitness Through Motion, Inc. will advise guests as soon as practically possible before departure date. Guests will then have the choice of accepting the major change with such alternative arrangements for the trip and appropriate compensation as Fitness Through Motion, Inc. shall offer or choosing an alternative departure date for the tour, or withdrawing from the contract and accepting a full refund of all monies paid to Fitness Through Motion, Inc..

13. Payment of the required deposit or any partial or full payment on a Fitness Through Motion, Inc. package constitutes consent to all provisions, conditions and general information contained in this brochure and further constitutes an acknowledgement that all of the terms and conditions have been read and understood by you. The terms and conditions of Fitness Through Motion, Inc. may not be altered or modified without the express written consent of an authorized officer of Fitness Through Motion, Inc.

I agree to all Maui Bootcamp Terms and Conditions

Your signature will be required at the time of your evaluation and you agree to the terms now!

I agree to all Terms and Conditions listed above

Electronic Signature

Date (MM/DD/YYYY)

For More Information, Contact us at (562) 225-4181 or e-mail info@LongBeachBootCamp.com