Meeting Location:

Carriage Farm,

2 Clerico Lane, Bldg 2,

Hillsborough, NJ 

(Off Amwell Rd Bridge)

To register please complete and return this form

with payment to:

Be Fit Anywhere, LLC, 51 Camden Road, Hillsborough, NJ  08844

 

 

Last Name _______________________________ First Name ___________________________

 

Mailing address_________________________________________________________________

 

City ________________________________________________ State______ Zip ___________

 

Phone _______________________ Cell Phone: ___________________  (important for txt updates)

 

Email ___________________________________________

 

Mon / Wed / Fri  6:15 AM to 7:15 AM: 

Session 1:  4/12 – 4/30 ____  Session 2: 5/03 – 5/21 _____

 

3X per week ___ 1 Session @ $175 or ___ 2 sessions @ $350 (Check One) sessions $________  

 

2X per week ___ 1 Session @ $118 or ___ 2 sessions @ $336 (Check One) sessions $________  

Check which 2 days you plan to attend: ___ M ___ W ___ F

 

____ Saturday Mornings 4/17 – 5/22 (6 Saturday Mornings)

7:30 – 9:00 AM @ $200 Weekday and Saturday Session                        TOTAL: $_______  

 

Paying by: ___ Check ___ Mastercard  ___Visa or ___Discover

 

Credit Card#_______________________    Expiration Date: ______

 

Registration may be reserved with payment in full. Check, Visa, Mastercard, and Discover credit cards are accepted.  Price includes a $50 non-refundable fee for cancellation before sessions begins (2 weeks notice must be given).  Switching sessions will be subject to a $15   administration charge.

 

Waiver of liability & authorization: I, the below signed, authorize payment against the credit card listed and waive all claims for myself.  I acknowledge that I have voluntarily chosen to participate in a program of progressive physical exercise which can enhance the musculoskeletal and cardio-respiratory systems.  I will complete a health history form.  In signing this document, I acknowledge being informed of the possible strenuous nature of the 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 risk for my health and well being and hold harmless, Be Fit Anywhere, LLC, Carriage Farm, LLC, Edward & Susan Clerico of any responsibility as well as the trainer, instructor, facility or any persons involved with this program and testing procedures. Further, I agree to permit use of my name and picture in any website, broadcast, telecast, or print media account of this event.

 

X____________________________________________

Signature of Participant or Parent/Guardian (if under age 18)

 

Additional registration forms and more information is available at www.befitanywhere.com

or call Godelieve Babey at 908.295.4411

 

 

 

 

(NJ Sales Tax included)                  Office Use Only             RCVD _______               Registered_________        Client Card_______                   Email Confirmation _________

Be Fit Anywhere, LLC 

2010 Summer Boot Camp Registration Form