Fitness For Living - Outdoor Fitness Boot Camp. David Clair's Outdoor Fitness Boot Camp for all abilities. Boulder, Broomfield, and Denver Colorado
         

Trial Boot Camp Participant Information Form


Congratulations! The first step is often the hardest.

Give yourself a pat on the back for deciding to get a taste of the Boot Camp experience.

Our camps are designed to challenge a range of abilities and we would appreciate it if you would complete this form so our Camp Trainer will know a bit about you even before you show up at camp.   As we have a number of camp locations and class times we will also ask you to give us two days and/or times that you would like to attend. We will send you back a confirmation with the date and class time chosen as well as what to bring to camp, where we meet, and Camp Trainer info.    

We look forward to seeing you soon.

If you do have any questions don't hesitate to contact me at 303-550-3491.

David
Fitness For Living




Name:                 

Email Address: 

Phone:                

Age:                     

How Did Your Hear of Us:    



Please let us know your preferred Boot Camp location and give us two dates and the class time (or times) for us to choose from for the classes that you would like to attend (give us a date in the next 2-14 days). Usually we can accommodate your request.

Here are your class choices:
 • Scott Carpenter, Boulder
       > 6:10-7:20 am      (M/T/W/TH/F)
      > 7:35-8:45 am, 9-10:10 am (women’s camp) & 5:30 - 6:40 pm      (M/W/F)
• North Boulder Park, Boulder
      > 6:10-7:20 am      (M/W/F)
• Longmont
      > 6:10-7:20 am      (M/W/F)
• Lafayette
      > 6:10-7:20 am, 7:35-8:45 am & 9-10:10 am (women’s camp)      (M/W/F)


Indicate preferred days and time(s) here:



Please answer the following questions and let us learn more about your motivation and health & fitness background.


  1. Do you have any concern with participating in the following activities: jogging, sprinting, hopping/jumping or doing sit-ups, pull ups, push ups, etc.? If yes, which ones and why?

    Do you have any health concerns or physical ailments, problems or limitations? Do you have or have you had any knee, back or shoulder problems?




  2. Please rate the following.   (1=poor, 3=average, 5=excellent )

    Overall fitness level                         1      2      3      4      5     


Health Screening & Medical History

Engaging in regular physical activity is fun & healthy and helps our body to work efficiently. Being active is safe for most people, however some people may need to consult a physician before they become much more physically active than they are used to. If you are between the ages of 18-64, this initial health screening will let you know if you need to consult a physician before you start Outdoor Boot Camp. If you are 65 years of age and are not regularly active, then consult your physician.
  1. Has your doctor ever said that you have a heart condition and that you should only do physical activity recommended by a doctor?
         Yes     No

  2. Do you feel pain in your chest when you do physical activity?
         Yes     No

  3. Do you lose your balance due to dizziness or do you ever lose consciousness?
         Yes     No

  4. Do you have a bone or joint problem that could be made worse by a change in your physical activity?
         Yes     No

  5. Is your doctor currently prescribing drugs for your blood pressure or heart condition?
         Yes     No

  6. Do you know of any other reason why you should not do physical activity?
         Yes     No
If you answered YES to one or more questions, we recommend that you consult with your doctor prior to starting your session with Fitness For Living. If you answered NO to all the above questions then we can be reasonably sure that you can start becoming much more physically active. Be sure to build up gradually and respect your current level of fitness.

Do you have any of the following? (check off any that apply)
heart disease
unusual shortness of breath
back pain (describe below)
seizures
heart murmur or irregular beat
lightheadedness or do you faint
joint pain (describe below)
asthma
chest pain with exertion
cramping pains in legs or feet
muscle pain or injury (explain below)
other (describe below)
To the best of my knowledge, the above information is true.
Yes     No

To complete this registration you must 'sign' at the bottom of this form


Assumption of Risk

I understand that sports and conditioning programs are a test of physical and mental strength which poses risks of bodily injury, property damage, or death. I attest that I am in good physical and mental health and can not hold liable David Clair or Fitness For Living for any damages that may occur during our training and coaching together. Any questions that may have occurred to me have been answered to my satisfaction. I understand that I am free to withdraw from this program upon written notification to my trainer.

I understand that Fitness For Living reserves the right to take photographic or film records of any of their classes, and hereby agree that Fitness For Living may use such photographic or film records for promotional and/or commercial purposes.

I also understand the Fitness For Living trainers have the right to disqualify me from any activity, if in his or her judgment, I am incapable of that activity or if my continued participation will endanger me and/or the safety of others. I understand it is my obligation to inform the Fitness For Living trainers in advance of partaking in any activity of any medical or physical disability or limitation that may limit me or render me unable to perform or safely complete that activity. I further acknowledge that I am best able to evaluate my own physical and medical conditions and limitations. My continued participation after disclosure of any limitations shall be at my own risk.


By signing this contract, I understand that I am participating at my own risk and release Fitness For Living of all liability.

Signed by: