KUILSRIVER FREE 4 Week BOOTCAMP Pre Registration form

  • KUILS RIVER BOOTCAMP Pre - Registration Form MAY 2022

    Please fill in the form below.

  • NOTE: Please complete this form TRUTHFULLY. Failure to do so, could lead to your disqualification from the Challenge!

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  • How do you rate your fitness level?*

  • Have you or are you using or intending to use any supplement e.g. meal replacement/sports products which you intend to use inconjunction with the 4 Week Boot Camp Challenge?  E.g. Evox, USN, Herbalife, Herbex, GI Lean, Muscle Tech, SSN, HMT, Annique, etc.

  • Have you traveled internationally in the last 14 days?*
  • Have you been in contact with someone in the last 14 days who was confirmed to have Covid-19?*
  • Are you currently suffering from any of the following?*

  • 2 options to choose for Bootcamp..*

  • Please list 5 Friends/Family that may be interested in joining the Boot Camp Challenge and working out with you.  Please provide their Name, Surname & Cellphone Number. (failure to do so will result in your  pre registration being forfeited)

     

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    • PLEASE COMPLETE WITH A MIN 5 NAMES AND CONTACT NUMBERS OF FRIENDS AND FAMILY TO SECURE YOUR SPOT. (Compulsory) 
    • Please note, that ALL Participants younger than 18 years, will need the signed consent of a Parent/Guardian at the Orientation meeting.
    • Please consult your Doctor before participating in any strenuous exercises, neither Boot Camp nor any Coaches associated with the Boot Camp, will be held liable for any injuries incurred during or as a result of the exercises.

    • I hereby accept all risks associated with my participation in the FREE BOOTCAMP  (FB) Personal Training Programs and release and forever discharge the FB, its independent distributors, employees - including its personal trainers (“TRAINER”), The FB Corporation, its board of Trustees, and any other officers, agent or volunteers of FB(“RELEASEES”) from any and all responsibilities or liability from injuries or damages resulting from or connected with my participation in any of the exercise or activity programs whether arising from the negligence of the RELEASEES or otherwise. 

      1. I acknowledge and fully understand that I will be engaging in training activities that potentially involve the risk of serious injury, permanent disability or death. Other possible risks may include social and economic losses which might result not only from the RELEASEES own actions, inactions, or negligence, but the actions, inactions, or negligence of others, the condition of the premises or any equipment. Further, that there may be other risks not known or not reasonably foreseeable at this time. I hereby assume full responsibility for all the foregoing risks, known and unknown, and accept responsibility for the damages following any injury, permanent disability, or death. 

      2. I further acknowledge and understand that the FB, its personal trainers and other independent distributors, members or employees are not licensed dieticians or physicians and that any information or guidelines provided by AWFC, its personal trainers or independent distributors other employees carries no warranty of any kind, expressed or implied, including, but not limited to, warranties regarding safety or suitability for a particular purpose. 

      3. The FB and its independent distributors or employees will implement the most effective principals to help the participant achieve his or her goals within the TRAINER’S scope of practice, but cannot guarantee that its products or workouts will be safe, effective or suitable for everyone. For that reason, all such products and services, programs, techniques and materials embodied in such products and services, are offered without warranties or guarantees of any kind, expressed or implied, and the TRAINER, FB and its independent distributors or employees disclaim any liability, loss or damages that may result from their use. 

      4. I understand that a physician’s approval is highly recommended prior to participating in this program 

      5. I also acknowledge that some exercise programs might be held outside of the Wellness Center, and hereby accept all risk associated with all offsite exercise programs.

      6. I have read this document in its entirety and agree to adhere to all its precepts, as well as all other terms and conditions of the FB’s Personal Training Program. I understand the risks and benefits of the program and any questions that I may have had have been answered to my satisfaction. Upon participation, I do hereby discharge, release and hold harmless the TRAINER, FB and its independent distributors, members or employees FB and  Wellness Center, The FB Corporation, its Trustees, officers, agents and employees from any and all liability for damage claims or losses of any kind or character whatsoever resulting from any injury or condition I may suffer, or resulting from my participation except if such damage(s) or injury(s) is primarily the direct result of gross negligence or misconduct of the RELEASEES and not caused in part by my own negligence.

    • DECLARATION

    • I hereby declare to the best of my knowledge that the information disclosed is correct at the time of completion. I further undertake to inform the Bootcamp should I be diagnosed with COVID-19 within the next 14 days so as to facilitate contact tracing.


    • Submission of this form is a confirmed signed copy of this declaration
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