Women's Adventure Fitness Boot Camp in Cave Creek, bootcamp for women, adventure boot camp, womens fitness program, womens weight loss, exercise camp, womens camp, exercise, workout programs, outdoor exercise

Cave Creek Member Camper Registration Form

Please Note: This option is for returning campers only, if you are a new camper please click here to return to our “New Camper” registration page and if you are a returning camper and are not interested in purchasing a membership at this time, please click here to be re-directed to our “Returning Camper” registration page.

Thank you for choosing to become a member of Cave Creek Adventure Boot Camp!

We’ve created this membership option to thank you for being a loyal customer. Here are the advantages of membership to Cave Creek Adventure Boot Camp:

25% off of our regular boot camp price!

After your initial membership registration - no more forms, you will be automatically registered for each session!

Payments will be automatically drafted from your credit card or bank account each month.

Membership Options:

Option 1: 3 days/week @ $100/month, for an annual savings of $398.00!

Option 2: 4 days/week @ $125/month, for an annual savings of $498.00!

Option 3: 5 days/week @ $150/month, for an annual savings of $598.00!

To become a Cave Creek Adventure Boot Camp member, simply agree to the following and complete and submit your registration & payment information.

Terms of Agreement:

✓  I agree to make a minimum of six consecutive monthly payments to Cave Creek Adventure Boot Camp.

✓  I understand that all payments will be made to Cave Creek Adventure Boot Camp via Electronic Funds
     Transfer (EFT) one time each month.

✓  After six months my membership will continue on a month to month basis until I notify Cave Creek Adventure Boot
      Camp otherwise.

✓  My membership can be cancelled at any time after six months of its inception without penalty.

The cancellation of the membership will be immediate:

I agree that there will be no refunds, and no credits.

I agree that all membership privileges end immediately upon cancellation.

✓  I agree to pay a $100 early termination fee if I choose to cancel my membership within six months of its inception.

✓  My membership can be suspended due to medical inability to exercise. The duration of the suspension of the
      membership will equal the time missed do to inability to exercise.

✓  Cave Creek Adventure Boot Camp will offer a minimum of 8 four-week boot camp sessions per calendar year.

Fields with * are required fields.

I agree to all terms and conditions listed above. *
By entering your name here, you signify that you have read and agree to abide by the Membership Terms of Agreement listed above. *
REGISTRATION INFORMATION:
Full Name: *
E-mail Address: *
Address: *
City: *
Zip: *
Date of Birth: *
Your Home Phone: *
Your Work Phone:
Emergency Contact & Phone: *
Fax Number:
Your Job Description?
Membership Type: *	5 days/week - $150/month 4 days/week - $125/month 3 days/week - $100/month
Camp Start Date and Time *
Is this your first camp? *	Yes No
If you answered no above, when was the last camp you attended?
How did you find out about Cave Creek Boot Camp?^
^If you answered Friend/Referral above, please specify the name of the Cave Creek Camper who told you about us:
I rate my current fitness level as a: *
What are your fitness goals for the next 3 months?
MEDICAL HISTORY PLEASE NOTE: It is wise to seek your doctor's advice before beginning any health/fitness/nutrition program!
1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?
2. Do you take any prescribed medication on a permanent or semi-permanent basis? If yes, please specify.
3. Do you have a seizure disorder?	Yes No
4. Do you have diabetes? If yes, list medications:
5. Have you ever been found to be anemic (low blood count)?	Yes No
6. Do you have High Blood Pressure (hypertension)? List medications if applicable.
7. Do you have or have you ever had any of the following diseases: Heart Disease, Lung Disease, Liver Disease, Kidney Disease. If you answered yes to any, please specify.
8. Do you have asthma? (List medications, if applicable)
9. Have you ever had a severe neck injury? If yes, please describe:
10. Have you ever been knocked out? Describe:
11. Do you wear glasses or contact lens?	Yes No
12. Have you had a broken bone or fracture in the past 2 years? If yes, please describe:
13. Have you ever injured your back? If yes, please describe:
14. Do you have back pain?	Never Seldom Occasionally Frequently with vigorous exercise or heavy lifting
15. Have you had knee pain in the past 2 years that has disabled you for longer than a week? If yes, please describe:
16. Do you have other physical conditions that cause pain? Describe:
17. Detail any surgical procedures:
RELEASE This waiver and release is entered into between the undersigned and Cave Creek Adventure Boot Camp, its instructors, officers, affiliates, subsidiaries and executors. The purpose of the Cave Creek Adventure Boot Camp Program offered by Jodi Norton, is to provide fitness instruction and coaching for various levels of individuals/athletes. The undersigned hereby acknowledge that the following was explained to me and/or agree to the following: 1. Acknowledges that the instructor is not a physician and is not trained in any way to provide medical diagnosis or any other type of medical advice. 2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but Cave Creek Adventure Boot Camp does not guarantee neither good nor bad will occur, nor guarantees the training advice given by Cave Creek Adventure Boot Camp or its instructors 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 and activities, 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 Cave Creek Adventure Boot Camp, its instructors, officers, affiliates, and executors 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 no representatives of Cave Creek Adventure Boot Camp nor anyone else has 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. The undersigned agrees to confidentiality with respect to Cave Creek Adventure Boot Camp and all services provided by same. Undersigned agrees to refrain from disclosing, directly or indirectly, any and all aspects of Cave Creek Adventure Boot Camp. The undersigned agrees to non-compete within a 50 mile radius of Cave Creek Adventure Boot Camp for a period of 5 years from date of participation.
By clicking this checkbox, I signify that I have read and agree with all the above RELEASE text. *
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 to which you will need to adhere. Please read, then agree to each of the following by entering a checkmark in the box:
I agree that I will not consume alcohol or eat fast food during Boot Camp. *
I understand that diet and nutrition will affect my fitness goals and performance during Boot Camp. *
I agree not to use foul language during Boot Camp. *
I agree not to eat or say the words Twinkie, Donuts, Ho-Hos, Ding Dong, or Cup Cake during the course of Boot Camp. *
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. *
I will remember to set my alarm and arrive at camp ON TIME. *
(Any violation of the above PERFORMANCE PLEDGE 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, for reasons beyond my control, I am not able to complete the one I originally joined. THE CREDIT MUST BE USED WITHIN 90 DAYS OF ORIGINAL SIGN UP DATE. Camp fees cannot be used towards any other products or services provided by Cave Creek Adventure Boot Camp. *
I will bring a positive attitude and expect to have FUN! *
By clicking this checkbox, I signify that I have read and agree to all Terms and Conditions listed above. *
By entering your name here, you signify that you are affixing your signature electronically to this form. *


* Required

Click to return to the Registration start page without completing this form

For More Information, Contact us at (602) 326-5670 or e-mail jodi@cavecreekbootcamp.com