Registration Form

Please fill out the Registration below and Medical History Questionnaire. Once we have received your Registration, Medical History Questionnaire and boot camp payment, we will send you a confirmation email with instructions for setting up your pre-camp evaluation.

Medical History Questionnaire

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* Required fields
Name *
E-mail Address *
First Name *
Last Name *
Address *
Address 2 *
City *
State *
Zip Code *
Home Phone *
Cell Phone *
Work Phone
I rate my current fitness level at a ______. 10 being the highest and 1 being the lowest *
My fitness goal in this camp is: *
How did you hear about this fitness camp? *
If by referral, who can we thank?
What size t-shirt would you like for your FREE Bootcamp Fitness Shirt? *
Attendance Options *
Payment Option *

I have read and agree to the Privacy Policy *

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Medical History Questionnaire

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Contact: The Freedom Coach

email: freedombyfitness@gmail.com

phone: 708-704-7309, 708-596-8728

fax: 708-596-8720