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ABOUT US
411
FAQ's
PERSONAL TRAINING
CAMPS AND RATES
SUCCESS STORIES
REGISTRATION

PHOTOS

CHERYL BROUGHTON'S
PERSONAL WEBSITE
(www.cherylbroughton.com)




Swiggies

 

BOOT CAMP

SUCCESS STORIES

Broughton's Fitness Edge Boot Camp
and
Personal Training Registration

Registration is EASY - It takes less than 5 minutes!
To pay by credit card online, fill out the Health History form (Part 1) and credit card info (part 2)
Or, to register by phone, call Caroline, at 661.373.6174.
PLEASE DO NOT REGISTER UNLESS YOU ARE READY TO ENLIST. THIS IS NOT A FORM FOR REQUESTING MORE INFORMATION. IF YOU ARE ENLISTING WITH A FRIEND, TWO SEPARATE FORMS MUST BE FILLED OUT.
Name:
Email Address:
Mailing Address:
City:
State:
Zip Code:
Work Phone:
Home Phone:
Cell Phone:
How did you hear about us?
If referred by someone, please tell us their name:
If the Internet, which search engine?
Which search words did you use? (please be as specific as possible)
 

SPECIAL NOTE:
You may enlist after a course has started and can make up any/all of your missed days during the AM and PM camps. You can attend 1 day a week up to 6 days a week – you pick it. (Of course, you’ll get your best results by attending at least 3 or more days per week). You can even make up your missed days in advance (like when you know you’re going on vacation).

When would you like to start?
Which time of day:
How many BOOT CAMP workout sessions/weeks are you enlisting in?
How many PERSONAL TRAINING workout sessions/weeks are you enlisting in?
Age:
Family history of coronary artery disease?
Hypertension: 140/90 or higher blood pressure?
High Cholesterol?
Do you have Diabetes?
Do You Smoke?
I currently exercise:
Are you enlisting with a friend/spouse?
Yes
No
If yes, please provide their name:
I'd like to pay:
Sweatshirt size:
A few goals I'd like to achieve in this program are:
  SPECIAL NOTE: By submitting this form, you understand and agree
that this contract is electronically signed and as such, you are waiving your
right to a physical signature and agreeing that this order form is enforceable
without your physical signature. 
This is my Electronic Signature:
I agree, let's go!!
I disagree. I'll have to think about it
I have read the entire Waiver of Liability statement (SEE BELOW)
I have read it
I have not read it
 
IMPORTANT INFORMATION

 

Once we have received this Health History/Registration form, we will confirm that your spot has been successfully reserved and will contact you to book your health screening.   All new recruits must go through a mandatory Health Screening prior to the start date (which is included in the price of your Boot Camp) and will last for one hour.  This form must be submitted PRIOR to participation in Boot Camp.

Terms and Conditions. Please read carefully.

 

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