New Silver Beach Summer Boot Camp Series | Fitness Directions Fitness Directions | 24 Spring Bars Road, Falmouth, MA | (508) 495-6500 | Fitnessdirections.Com

New Silver Beach Summer Boot Camp Series | Fitness Directions Fitness Directions | 24 Spring Bars Road, Falmouth, MA | (508) 495-6500 | fitnessdirections.com

This summer join the trainers from Fitness Directions, Pilates and Personal Training Studio, for a full body, cardio and strength workout at your location! We’ll bring the equipment, you bring your water bottle, towel, energy and desire to stay healthy and fit this summer. The workouts are multi-level and require no previous experience. Each week we will give you a new set of workouts that will challenge you and keep you motivated. Whether you register for the whole summer series, or occasionally drop-in, you’ll be sure to see results.

8 Week Summer Series | JULY 7th- AUGUST 27th | Tues & Thurs 8:00a- 9:00a Meets @ New Silver Beach Tennis Courts

NSB Summer Package (16 Classes) $128 NSB Half Summer Package (8 Classes) $80 NSB Summer Drop-in (1 Class) $15 *Packages can be shared with up to 3 members of the same family. Each person you wish to share with must be added to the package at the time of purchase. You will not be able to add people to your package after purchasing.

Cancellations will be made by 7:30 AM on the day of the scheduled class if it is RAINING. We will post on the Fitness Directions Facebook Page and you can call the studio at (508) 495-6500 for cancellation updates. If the scheduled class is cancelled by the trainer because of rain or any other reason, you will be able to make up your class at our studio in Falmouth during any “Punch Card” class on our regular schedule before August 31, 2015. Please sign up ahead of time for make-up classes. There will be no makeups for missed classes or unused sessions. ------Registration Form Contact Information: Package Selection (check appropriate box)

Name: ______NSB Summer Package (16 Classes) $128

Email: ______NSB Half Summer Package (8 Classes)$80

Phone: ______NSB Summer Drop-in (1 Class) $15

Payment: CASH CHECK Credit Card (MasterCard/Visa)

CC Info: Card # ______Exp. Date ____/____/______Code:______

Name on card if different than your name of person registering: ______

Health History Form & Consent Waiver Please answer each question by printing the necessary information. Your answers will be kept confidential.

Client Information and Release Form

NAME ______DOB ______

MAILING ADDRESS ______

CITY ______STATE ______ZIP______

PHONE NUMBER(s): HOME______CELL ______

EMAIL: ______

In case of emergency, please notify: NAME ______Relationship ______Phone Number: ______

How Did You Hear About Us:

__ Website __ Social Media __Magazine/Newspaper __Google/Search Engine

__ Friend/Family (please specify):______

General Medical History and Information Please note: In order to assist you in the development of a rewarding physical fitness program, we need to have your honest and accurate responses to the following questions:

Are you under the care of a physician, chiropractor, or other health care professional for any reason? If yes, list reason:______

Are you aware of any disease or disorder that would complicate your participation in an exercise program?______

Has your doctor ever told you that you have a bone or joint problem that has been or could be made worse by exercise?______

Are you taking any medications? If yes please indicate the type of medication, dosage, frequency and reason(s) for taking it: ______

Please list any allergies:______

Has your doctor ever said your blood pressure was too high? ______Are you over age 65? ______Are you a smoker? If so, what is your smoking frequency? ______Are you unaccustomed to vigorous exercise? ______Is there any reason not mentioned here why you should not follow a regular exercise program? ______Health History Form & Consent Waiver Please answer each question by printing the necessary information. Your answers will be kept confidential.

Please describe any past or current musculoskeletal conditions you have incurred such as muscle pulls, sprains, fractures, surgery, back pain, or general discomfort: Head/Neck: Upper Back:

Lower Back: Shoulder/Clavicle:

Arm/Elbow: Wrist/Hand:

Hip/Pelvis: Thigh Knee:

Lower Leg/Ankle/Foot: Other:

Have you recently experienced any chest pain associated with either exercise or stress? If so, please explain: ______

Do you have or have a family history of any of the following conditions? (Please specify yourself [Y] or Family History [FH]): ___Heart Disease ___High Cholesterol ___Stroke ___Cardiovascular Disease ___Other heart conditions ___Recent Illness/Operation ___Heart Attack ___Epilepsy/Convulsions ___Unusual Shortness of Breath ___Hypertension ___Diabetes ___ Lightheadedness ___Gout ___Obesity ___Asthma/Exercise Induced ___Abnormal EKG ___Orthopedic Problems: ___Pulmonary Disease ___Angina ___OTHER:

Informed Consent/Waiver By signing this document, I acknowledge that I have been informed of the need to obtain a physician’s examination and approval before beginning this exercise program. I understand that the program is strenuous in nature and choose to participate voluntarily. I accept all responsibility for my health and well-being and any resulting injury that may affect my health in any way. I hold harmless of responsibility in the instructor, trainer, facility or any persons involved with this program.

By signing this document, I acknowledge that I have voluntarily chosen to participate in a program of progressive physical exercise. In signing this document, I acknowledge being informed of the strenuous nature of this program and the potential for unusual, but possible, physiological results including but not limited to abnormal blood pressure, fainting, heart attack, or death. By signing this document, I assume all risks for my health and well-being and hold harmless of any responsibility the instructor, facility, or any persons involved with this program.

By Signing this document I acknowledge that if anyone is hurt or property damaged during my participation in this activity, I will have no right to make a claim or file a lawsuit against the facility, its agents, owners, officers, employees, the instructor, director of the program, or any other person or entity acting in any capacity on behalf even if they or any of them negligently caused such injury or damage.

My signature below indicates that I have had sufficient opportunity to read this document and that I have read it and understand it affects my legal rights. I agree to be bound by its terms.

Signature of Participant Date

______Print Name