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Somers Boot Camp Registration for Returning Campers
Westchester Somers Boot Camp Class
REGISTRATION

You now have 2 options:
A. You can print this form and send it in with payment by mail
B. Register O
nline
Fill out the online form below to register via internet. Click on Submit to go to the payment page.
Payment Page: Pay via Paypal. Choose your class and finish your online registration. A PayPal account is not required to pay via PayPal.

NOTE: Spaces fill quickly for this unique experience. We cannot guarantee your space until we have received payment.

If paying by check, please make check out to:
Westchester Somers Boot Camp
3 Bridge Lane
Somers, NY 10598
GetFit@WestchesterBootCamp.com
Phone: (914) 960-4494

Registration Form
Personal Information
Name Email Address
Additional Information (Leave Blank if this has not changed)
Address    
City State / ZIP /
Profession Country
Date of Birth (mm/dd/yyyy) Phone Number
Cell Number Fax Number
       
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:
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
What camp are you joining?
Choose your camp frequency and cost.
Form of payment:
Comments and Release
Comments, Notes or Message:

NOTICE: It is wise to seek your doctors advice before beginning any health/fitness/nutrition program!

RELEASE: (Scroll to read the entire Release).


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 and check each one.

I agree to all Terms and Conditions listed above

Signature, Date and SPAM Verification
Electronic Signature
Date (MM/DD/YYYY)

 

 

For More Information Contact Carla at (914) 960-4494 or e-mail GetFit@WestchesterBootCamp.com
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