EZ8 Running Camp - Running - Rosa Hurst & Roni Leahy, Instructor

Running Camp Re-Enlistment Form & Release

Thank you for registering for another exciting EZ8 Running Camp. Please complete and submit the short form below (note that required fields are highlighted in red text).

EZ8 Running Camp Re-Enlistment Form

In order to use this form, each statement below must be true. Please check each box to confirm your agreement.

I have attended an EZ8 Running Camp within the past six (6) months.

I confirm that my personal contact information has not changed from my original registration.

I confirm that my emergency contact, medical history, and medical status have not changed.

Should any of these statements be untrue, then you will need to fill out a new registration form; otherwise, your original agreements on file are still binding.

First and last name:

E-mail address:

Emergency Contact:

Emergency Contact Number:

Date of Birth:

Camp date:

Camp Level :

Beginner Intermediate

Type of Camp:

4 WEEK CAMPS:

Beginner

Intermediate

This is my first EZ8 Running Program:

Yes

No, last program attended (Month & Location):

Emergency contact:

Phone:

I rate my current
fitness level as a:

(1-10), 10 being high

I was referred by:

How did you find us?
(Please be specific. Thanks!)

My main goal is to:

My minute mile is:

(Date ran)

Comments:

RELEASE

This release is entered into between the undersigned and North Atlanta EZ8 Running Camp/Iron Ballet LLC. The purpose of the EZ8 Running Camp/Iron Ballet LLC is to provide running instruction and coaching for various levels of athletes/individuals.

The undersigned hereby acknowledge that the following was explained to me and/or agree to the following:

Acknowledges that Sherry Shelton is not a physician and is not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice.
Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that EZ8 Running Camp/Iron Ballet LLC does not guarantee neither good nor bad will occur nor guarantees the training advice given by the EZ8 Running Camp/Iron Ballet LLC will produce good nor bad results.
Acknowledges that the undersigned has been told if they feel tired, feel pain or feel out of the ordinary in any way either related to your training, or otherwise, that the undersigned should contact a physician at once.
Acknowledges that boot camps, aerobic classes, martial arts, kick boxing, running, kung-fu, weight training, obstacle courses, and any other related sports are an extreme test of one's mental and physical limits and carry with it potential for damage or loss of property, serious injury and death. That the undersigned assumes the risks of participating in these types of events/activities including the inherent dangers of the natural elements, that they are fit, and they have a regular medical physician they can contact regarding any medical problems that they might develop. The undersigned expressly waive, release, discharge and agree not to sue from any liability of death, disability, personal injury, or action of any kind and the EZ8 Running Camp/Iron Ballet LLC for the undersigned participating in said sporting events and/or training for said sporting events.

The Undersigned agrees that this is the full agreement between the parties, that the EZ8 Running Camp/Iron Ballet LLC, nor anyone else has not verbally contradicted any of the terms of this release and that the undersigned has entered into this agreement free and voluntarily without force or coercion.

Check the following:

I agree that I will not consume alcohol during the month of the Running Camp. Any violation will result in a 1 mile run per occurrence.

I agree not to use foul language during the EZ8 Running Camp. Any violation will result in a 1 mile run per occurrence.

I agree not eat or say the words Twinkie, Donuts, Ho-Ho's, Ding Dong, or Cup Cake during the course of the EZ8 Running Camp. Any violation will result in a 1 mile run per occurrence.

I agree to show up for my runs every day unless it is an excused absence from my doctor or pre-approved with the running directors. Any violation will result in a 1 mile run per occurrence.

I understand that photos or video may be taken during the course of my involvement in the Running Camp, which may be used for promotional purposes. I understand that my "before & after" photos will not be used for any promotional purposes unless I give written authorization.

I understand there is no refund policy, but I can receive a credit (for unused portion of the program) towards a future running camp if I'm not able to complete the one I originally joined (due to injury or major illness). We also have an alignment with North Atlanta Boot Camp, and that credit may also be applied to one of their fitness boot camps.

I will remember to set my alarm and be at camp on time.

Your signature will be required at the time of your evaluation, and you agree to the terms now!

PAYMENT

NOTE: Your registration will be confirmed only after receipt of payment. Space is limited, so please submit your payment immediately.

Please select your payment method:

Paying online with credit card.

Mailing check.

By submitting this form, you are agreeing to the terms above!

North Atlanta Running for Women www.NorthAtlantaRunning.com Atlanta, Georgia
For more information call 404-978-5362 or write to info@ironballet.com