Registration

Are you ready to start your adventure? Follow these instructions:

  1. Print the registration form, or fill out the online registration form below.
  2. Reply by email or phone (604) 787-7738.
  3. You will be notified to schedule your pre-camp evaluation.

We accept VISA, MC, AMEX, Cash and Cheques. MC is currently seasonal and is only offered as an option March thru October. Please make cheques payable to B.C. Adventure Boot Camp Inc. Your payment is due in full at the pre-assessment evaluation.

Name:
Email:
Home Phone:
Work Phone:
Fax Number:
Street:
City:
Province:
Postal Code:
Profession:
Date of Birth:
Emergency Contact Name:
Emergency Contact Phone:
   
Boot Camp Date:
This is my first camp: Yes No
The last camp I attended was:
The location of my last camp:
   
I rate my current fitness level as (10 being highest)
I was referred by:
My main goal is to:
Payments can be made by cash or cheque.
 
BOOT CAMPER PACKAGES
Please select off the package you are interested in:
 
Nordic Walking Option: Include the evening Nordic Walking (Monday or Wednesday) with your 4 day program and pay only $39.95 more.
Yes No
*All Prices are Subject to Change and to Applicable Taxes.
*Please inquire about our Platinum & Corporate Rates.
 
RETURNING BOOT CAMPER PACKAGES
This package is ONLY available if you are a LIFETIME Member and have completed 10 Boot Camps.
 
Nordic Walking Option: Include the evening Nordic Walking (Monday or Wednesday) with your 4 day program and pay only $19.95 more.
Yes No
*All Prices are Subject to Change and to Applicable Taxes.
 
Confirmations and detailed instructions will be mailed prior to the start of Camp. Waiver must be signed prior to participation.
MEDICAL HISTORY
   
1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)? Yes No
2. Do you take any prescribed medication on a permanent or semi-permanent basis? Yes No
3. Do you have a seizure disorder (epilepsy)? Yes No
4. Do you have diabetes Adult or Juvenile? Yes No
5. Have you ever been found to be anemic (low blood count)? Yes No
6. Do you have High Blood Pressure (hypertension)? Yes No
7. Do you have or have you ever had the following diseases?
Heart Disease: Yes No
Lung Disease: Yes No
Kidney Disease: Yes No
Liver Disease: Yes No
8. Do you have asthma? Yes No
   
9. Have you ever had a severe neck injury? Yes No
If yes, please describe:
   
10. Have you ever been knocked out? Yes No
If yes, please describe:
   
11. Do you wear glasses or contact lenses? Yes No
   
12. Have you had a broken bone or fracture in the past 2 years? Yes No
If yes, please describe:
   
13. Have you ever injured your back? Yes No
If yes, please describe:
   
14. Do you have back pain? Never
Seldom
Occasionally
Frequently with vigorous exercise or heavy lifting
   
15. Have you had knee pain in the past 2 years that has disabled you for longer than a week? Yes No
If yes, please describe:
   
16. Do you have other physical conditions which cause pain? Yes No
If yes, please describe:
   
17. Detail any surgical procedures:
   
18. What are your goals for the next three months?
   
19. Have you had your body fat tested? Yes No
  If yes, what percentage?
   
20. Are you training for a specific event? Yes No
If yes, please describe:
   

NOTICE: It is wise to seek your doctors advice before beginning any health or fitness program!

RELEASE

(This part of registration will be completed at the pre-assessment evaluation - not online)

This release is entered into between the undersigned and BC Adventure Boot Camp Inc., its officers, affiliates, and executors in addition to the District of Maple Ridge, the District of Pitt Meadows, Parks and Leisure services, commission and School District #42. The purpose of BC Adventure Boot Camp is to provide fitness instruction and coaching for various levels of athletes/individuals.

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

  1. Acknowledges that Mari-Ann Drevvatne is not a physician and is 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, and though BC Adventure Boot Camp Inc. guarantees results, the individual is completely responsible for setting REALISTIC goals, attending ALL events, seminars, tours, and classes that are required and is willing to follow ALL nutrition guidance set by BC Adventure Boot Camp. We cannot guarantee results for participants with pre-existing medical conditions that either hinder weight loss, (Example: thyroid conditions) or require special medical supervision. (Example: Diabetes, High Blood Pressure, Kidney or Renal conditions, etc.)
  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, medicine ball training, agility training, running, weight training, core strength training, obstacle courses, hiking, 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/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 BC Adventure Boot Camp Inc. 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 BC Adventure Boot Camp Inc. nor anyone else has not 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.

Initial the following:
____ I agree that I will not consume alcohol during the boot camp. Any violation will result in twenty push-ups per occurrence.
____ I agree to not use foul language during boot camp. Any violation will result in twenty push-ups per occurrence.
____ I agree to not eat or say the words "Tim-Bits, Krispy Kreme donuts, frappucinos, french-fries, pizza, ice cream, Slurpees, chocolate bars, chips, pies, pastries, Ho-Ho's, Ding Dongs, or cupcakes" during the course of Boot Camp. Any violation will result in twenty push-ups per occurrence.
____ I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with Boot Camp directors. Any violation will result in twenty push-ups per occurrence.
____ I understand that under no circumstances is video or photography to be taken by anyone, except Mari-Ann or BC Adventure Boot Camp. Photos or video (i.e. May be taken during the during course of my involvement in boot camp, however "before and after" photos will not be used for any promo purposes unless authorization is granted.
____ I understand there is NO Refund Policy, but I can receive a credit (for unused portion of camp) towards a future camp if I am not able to complete the one that I originally joined, provided I have a Doctor's Note.
____ I will remember to set my alarm and be at camp ON TIME.

(This part of registration will be completed at the pre-assessment evaluation - not online)

____________________
Signature
____________________
Printed Name
____________________
Date

Sports Nutrition 101 by Cory Holly Media Coverage Newsletter

Lose Weight & Feel Great!

Expected results when you complete camp are:

  • 3-8% reduction in body fat
  • 5-12 pounds of weight loss
  • 1-3" decrease in the midsection
  • 25% increase in strength
  • 25% improvement in endurance
  • Better relaxation
  • Greatly improved posture
  • 100% gain in self-confidence