Pre-camp Evaluation Please note: All fields are required. Personal Information Self Assessment & Additional Information I rate my current fitness level as: (1-10)1 - Low2345 - Medium678910 - High Is this your first adventure boot camp:YesNo Medical History Enter N/A for any section which is Not Applicable for you. Do you wear glasses or contact lenses?NoYes Do you have Asthma?NoYes Release This release is entered into between the undersigned and Hunterdon County Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the City of Hunterdon County. The purpose of Hunterdon County 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 Nancy Kennedy 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 Hunterdon County Boot Camp including Hunterdon County Adventure Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Hunterdon County Boot Camp including Hunterdon County 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, 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 Hunterdon County 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 Hunterdon County Boot Camp including Hunterdon County 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 to 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 Default 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 I agree to all Terms and ConditionsYesNo To use CAPTCHA, you need Really Simple CAPTCHA plugin installed.