Body Creation Summer Series Challenge Bootcamp

Body Creation Personal Training Fitness, Body Shaping & Self Defence

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COMP life 2018

For all New and Renewing REGISTRATIONS please enrol here:
2018 BOOTCAMP @ the park

* Indicates required field

Which camp are you registering for today? *

Program 2018 Bootcamp In The Park Casual program starts January 22nd 2018 casual $10.00 per session

Please select your program. Payment and Bonus Session Offer Choices available. Please complete enrolment form for all details.

Name *

First

Last

Address *

Line 1

Line 2

City

State

Zip Code

Country

Email *

Phone Number *

Height *

Date of Birth *

Age *

Weight *

Gender *

What are you aiming to achieve? *

Please provide name and contact details of a relative or friend in case of emergency. *

Name *

First

Last

Phone Number *

How did you hear about us? *

Local Paper Social Media Direct Mail Internet Search Word of Mouth Other

Select all that apply.

Which statement best describes you? *

I can eat just about anything I want and I don't gain weight. I find it difficult to gain weight I can lose or gain weight easily by adjusting my activity level and eating habits. I find it difficult to lose weight. I can gain weight easily and have to watch what I eat.

BODY TYPE - Please select the statement that best describes you.

Health History - Have you had, or do you suffer from any of the following? *

Heart Attack Stroke High Cholesterol Hypertension (high blood pressure) Do you smoke? Arthritis Breathing or lung problems Diabetes None of the above

Have you had, or do you suffer from any of the following?

Other. (Please describe briefly) *

Are you currently taking any medication that may cause a reaction during exercise? *

Yes No Unsure

If yes, please explain. *

Have you ever had major surgery? *

Yes No

If yes, please explain *

Please describe any injuries you have which may prevent or limit your movement. *

What is your most recent involvement in exercise/activity *

Describe any sports you play, active hobbies, gym or other physical activities you are taking part in. Include active pastimes such as cycling swimming or walking.

Please select your exercise level on a scale of 1-10 *

Please select your Fitness level on a scale of 1-10 *

Rate your diet/eating/nutritional habits on a scale of 1-10 *

Payment Options

Payment is by DIRECT DEPOSIT or Paid directly to your trainer
Direct Deposit Account Details:

Bank: Westpac
BSB: 033-003
Account #: 465-779
Account Name: Body Creation

Please include your name or reference number with the payment. A reference number will be emailed to you on receipt of registration.
Payment is to be made in full prior to each session
Participant numbers will be limited.
No refunds, credits or make-up sessions apply for missed sessions*

*Some exceptions may apply under special circumstances.

I would like the 6 for 5 Deal. *

Yes No

Simply Pay $50 via Direct Deposit or in cash to your Trainer and you will received 6 session credits. Save $10.00

I will be making payment by: *

Please Select Your Payment Method

Choose Payment Method *

Direct Deposit Cash to my Trainer

Have you read and understood the Boot Camp payment & refund conditions *

Yes

Additional comment or request *

Click to Register Now

For more information about our Bootcamp Program

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