To register for one of Val Strang's Burn Family Fit Camps, please complete the form below. Use this form ONLY if you wish to pay online with a credit card or by debit of your bank account via PayPal. If you prefer to pay by check or money order, please download the mail-in registration form by clicking here, instead of using this online form.
Full Name of Parent/Guardian Attending Camp Street Address City State Zip Home Phone Mobile Phone Work Phone Fax Number E-mail Address (Please use the email address associated with your PayPal account.) Your Age Your T-shirt Size: Choose... Small Medium Large X-Large XX-large List the names and ages of the family members who will be attending the camp below. They must be immediate family members and children must be 5 or older. Limit of 3 children, please call 314-941-8523 for exemptions and pricing. Adult #2 Full Name Age T-shirt Size: Choose... Small Medium Large X-Large XX-large Child#1 Full Name Age T-shirt Size: Choose... Kids Small Kids Medium Kids Large Kids X-Large Child#2 Full Name Age T-shirt Size: Choose... Kids Small Kids Medium Kids Large Kids X-Large Child#3 Full Name Age T-shirt Size: Choose... Kids Small Kids Medium Kids Large Kids X-Large
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I am signing up for the camp beginning this date: (Type Date As XX/XX/XXXX) At the following location: (Type Location Name) Some camp locations require payments be made directly to the park or facility, therefore we are not be able to accept online payments via PayPal for those locations. Those locations will denoted as such on the schedule/locations page. Please indicate an emergency contact, in the event an emergency occurs. This information will be used only in the event of an emergency. Emergency Contact Name: Emergency Contact Phone Number: NOTICE: It is wise to seek your doctor's advice before beginning any health/fitness/nutrition program! This release is entered into between the undersigned, Val Strang’s Burn Boot Camps, LLC, its officers, affiliates and executors. The purpose of, Val Strang’s Burn Boot Camps, LLC, is to provide fitness instruction and coaching for various levels of athletes/individuals. The undersigned individual hereby acknowledges that the following was explained to them and/or agrees to the following: 1. Acknowledges that Val Strang’s Burn Boot Camps LLC, Valeri Strang or any affiliated staff members are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice. 2. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves. However, Val Strang’s Burn Boot Camps, LLC, Valeri Strang or any affiliated staff member does not guarantee that either good or bad will occur, nor guarantees that the training advice given by them will produce good or bad results. 3. Acknowledges that the undersigned has been told that if they feel fatigued, feel pain or feel out of the ordinary in any way, either related to training, or otherwise, that the undersigned should contact a physician immediately. 4. Acknowledges that boot camps, martial arts, kick boxing, running, weight training, obstacle courses, and any other related activities are an extreme test of one's mental and physical limits and carry with it a potential for damage or loss of property, serious injury and/or death. Also, that the undersigned assumes all risks of participating in these types of events/activities. It is also agreed by the undersigned that they are fit, and that they have a regular medical physician that they can contact regarding any medical problems that they might develop. The undersigned expressly waives, releases and discharges liability or liability charges of any kind against, Val Strang’s Burn Boot Camps, LLC, Valeri Strang, or any affiliated staff member. The undersigned also agrees not to bring litigation or suit of any kind or dimension as a result of any liability of death, disability, or personal injury suffered by the undersigned. The undersigned also agrees to bring no action of any kind against, Val Strang’s Burn Boot Camps, LLC, Valeri Strang, any affiliated staff members either jointly or severally, or the owners, or members of any affiliated training or Boot Camp site or property, as a result of the undersigned participating in Val Strang’s Burn Boot Camps, LLC and/or training events or for any reason whatsoever. The Undersigned agrees that this is the full agreement between the parties. The Undersigned also agrees that Val Strang’s Burn Boot Camps, LLC, Valeri Strang, any affiliated staff member, or anyone else has not verbally contradicted any of the Terms of this release and that the undersigned has read and entered into this agreement free and voluntarily without force or or coercion. You must READ the terms below and CHECK EVERY BOX:
If you were referred to Burn Family Fit Camps by a person, please type their name below: If you found Burn Family Fit Camps by another source, please let us know: (Magazine Ad, Article, Flyer, etc.) After we receive this registration form, we will email you a bill through PayPal.com within 7 days. Registration will be complete upon receipt of necessary fees. NOTE: If you prefer to pay by check or money order, please download the mail-in Attendance Registration Form by clicking here, instead of using this online form. Your privacy is very important to us. All information provided will be treated as confidential. The information will not be disclosed to third parties or other government agencies, unless required by state or federal law. I have read and agree to this Registration and Release and consent to submit it electronically. Clicking the "Submit" button is my electronic signature. I understand that if I do not agree to these terms, I should discontinue my registration, and refrain from using this form. (Please click "submit" only once to avoid accidentally duplicating your registration.)
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