Boot Camp Registration Form

BCx Boot Camp, exclusively at Ultima Fitness

BOOT CAMP IS ONGOING. JOIN AT ANYTIME!

How did you hear about this program?
Name
Age
Home Phone
Cell Phone
We use email as our primary source of communication for this program. Please provide below:
PRINT Email Address
Address
Emergency Contact
Phone
Please list any physical limitations or concerns
Who enlisted you as a Boot Camp Trainee?
Member Status: Member Non-Member
Program Cost: $99 5 Week Intro $120 per month, unlimited classes $20 Day Pass, members $25 Day Pass, non-members
The discounted Non-Member Fee includes full use of facility including free childcare and classes.
We recommend all BCx Boot Camp members provide their own mat for class.
Yes! Please add a mat to my registration form at a cost of $20 No thanks
WRITE CHECKS PAYABLE TO: Ultima Fitness
CREDIT CARD INFORMATION MAY BE GIVEN OVER THE PHONE OR AT THE FRONT DESK.

Please fill out this form online and a representative will contact you within 24 hours to confirm your registration.
Verify you are a real person by entering the code below: