jumpstartregistration

Jumpstart to Fitness
One-Day Bootcamp Registration

* Indicates required field

Name *

First

Last

Gender *

Male Female

Age *

Height *

Weight *

Phone Number *

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Do you have any physical disabilities/limitations that would prevent you from running a 5k, hiking in the mountains, or participating in weight training? *

If yes, please explain *

Do you have any dietary concerns or allergies? *

If yes, please explain *

Shirt Size *

Emergency Contact

Emergency Contact *

Relation *

Phone Number 1 *

Phone Number 2 *

Emergency Contact coming as a parent or legal guardian? *

A $30 fee will be added for parent or legal guardian accompanying a minor. *

Option 1 Option 2 Option 3

Parent or legal guardian registration total: *

Non-Liability Agreement

All activities will be under the supervision of a certified fitness trainer. The 5K run and hike will take place outdoors on natural terrain and on a rugged trail. Eden Valley will not be responsible for strains, sprains or other injuries caused by falls etc. Attendees assume responsibility for being fit enough to participate in this program. *

Read and Accepted

Digital Signature Required: *

Jumpstart to Fitness One-Day Bootcamp Registration

Emergency Contact

Non-Liability Agreement

Jumpstart to Fitness
One-Day Bootcamp Registration