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Boot Camp Registration - Step 1

Registration Form
You will be notified to schedule your pre-camp evaluation (if needed for your program). * - required fields.
Camp Information
Camp *
Price
Personal Information
First Name *		Last Name *
Address *		City *
State *	ZIP: *	Country *
Date of Birth *	(mm/dd/yyyy)	Profession
Work Phone		Home Phone *
Email Address *		Fax Number

Self Assessment & Additional Information
I rate my current fitness level as a (1-10), ten being high.
I was referred by:
How did you hear about us?:
This is my first camp:	Yes \| No
If you answered "no", when was the last camp you attended:
My Main goal is:
Name of Emergency Contact & Phone Number	\|

For More Information, Contact us at (206) 713-7249 or e-mail info@seattlebootcamp.com