Group Training Registration

Please fill out the registration page below. Once we have received your registration and training payment, we will send you a confirmation email with instructions for setting up your evaluation.

All fields are required.

I am signing up for training beginning on:  
Located at:  
First Name:  
Last Name:  
Date of Birth: mm/dd/yyyy  
Address:  
Address 2:
City:  
State:  
Zip:  
Home Phone:  
Cell Phone:
Job Title:
Work Phone:
Email:    
Confirm Email:  
Password:    
Confirm Password:  
Emergency Contact Name:  
Emergency Phone:  
I rate my current fitness level as a:
(Use scale of 1-10, 10 being highest) 		 
My fitness goal in this program is:  
How did you hear about Fit Neighborhood?
If by Referral, please provide name:
What size would you like for your t-shirt?  
Payment Options:
  
Attendance Options  

Medical History Questionaire

  Question Yes
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?
3 Do you have a seizure disorder (epilepsy)?
4 Do you have diabetes; Type I (IDDM) or Type II (NIDM)?
5 Have you ever been found to be anemic (low blood count)?
6 Do you have High Blood Pressure (hypertension)?
7 Do you have or have you ever had Heart Disease?
8 Do you have or have you ever had Lung Disease?
9 Do you have or have you ever had Kidney Disease?
10 Do you have or have you ever had Liver Disease?
11 Do you have or have you ever had asthma?
12 Do you have or have you ever had a severe neck injury?
13 Have you ever been rendered unconscious?
14 Have you had a broken bone or fracture in the past 2 years?
15 Do you wear glasses or contact lenses?
16 Have you ever injured your back?
17 Do you have back pain? If YES, select the best answer below.
 




18 Have you had knee pain in the past 2 years that has disabled you for longer than a week?
19 Do you have other physical conditions, which cause pain?
20 Have you had any surgical procedures?
21 Have ever had your body fat tested?
22 Are you training for a specific event?
If you answered "YES" to any of the questions above, please explain your answers below. Please reference the question number in your explanation.

NOTICE:

It is wise to seek your doctor’s advice BEFORE beginning any health/fitness/nutrition program!

Informed Consent, Waiver, and Release Agreement

This waiver and release is entered into between the undersigned and Fit Neighborhood and South Atlanta Adventure Boot Camp its instructors, officers, affiliates, and executors.

The purpose of Fit Neighborhood and the South Atlanta Adventure Boot Camp Program is to provide fitness instruction and coaching for various levels of athletes/individuals.

The undersigned hereby acknowledges that the following was explained to me and/or agree to the following:

  1. Acknowledges that Fit Neighborhood and South Atlanta Boot Camp instructors are not physicians and are 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 Fit Neighborhood and South Atlanta Adventure Boot Camp does not guarantee neither good nor bad will occur, nor guarantees the training advice given by Fit Neighborhood and South Atlanta 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, 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 Fit Neighborhood and South Atlanta 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 Fit Neighborhood or South Atlanta 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.

I have read and understood the Waiver and Release.

PERFORMANCE PLEDGE
In the spirit of harnessing your best effort and providing optimum results from your training experience, we have established the following policies to which you will need to adhere. Please read and initial each one.

  I agree that I will not consume alcohol during training.
I agree not to use foul language in class.
I agree not to eat fried food during training.
I agree not to eat or say the words Twinkie, Donuts, Ho-Ho's, Ding Dong, or Cup Cake during the course of group training.
I agree to show up for training every day unless it is an excused absence from my doctor or pre-approved with my trainers.
I will arrive at class ON TIME.
(Any violation of the above 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 group training, 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 class) towards a future time if, for reasons beyond my control, I am not able to complete the one I originally joined. This credit WILL NOT be extended beyond the two (2) subsequent months. Training fees cannot be used towards any other products or services provided by Fit Neighborhood or South Atlanta Boot Camp.