Pre-camp Evaluation

Oakland Adventure Boot Camp Registration

Option A
If paying by check, please make check out to:
Oakland Adventure Boot Camp
1690 Arbutus Drive
Walnut Creek, CA 94595
info@oaklandbootcamp.com
Phone: (925) 285-5869

Option B
If registering online
Fill out the online form below to register via internet.
Click on Submit to go to the payment page.
Payment Page: Pay via PayPal using a credit card or by transferring funds.
Choose your class and finish your online registration.
A PayPal account is not required to pay via PayPal.
*Transaction fee applied when using a credit card.

NOTE: Spaces fill quickly for this unique experience. We cannot guarantee your space until we have received payment.

  • If you choose option A, Print this page and mail it in with payment.
  • If you choose option B: Fill out the form below and Click on SUBMIT.

Please note: All fields are required.

Camp and Payment Information

What camp are you joining?:
Choose your camp time:
Choose your camp frequency and cost:
Form of payment:

Personal Information

Name:
Email:
Phone Number:
Address:
City:
Zip:
Profession:
Date of Birth:


Self Assessment & Additional Information

I rate my current fitness level as: (1-10):
Is this your first adventure boot camp:
Last Camp attended:
My Main goal is:
I was referred by:
How did you hear about us?
Name of Emergency Contact:
Emergency Phone Number:


Medical History

Enter N/A for any section which is Not Applicable for you.

Are you allergic to any medication? List medications:
Do you take any prescribed medication? List medications:
Do you suffer from epilepsy? List medications:
Are you anemic? List medications:
Do you have Diabetes? List medications:
Do you have High Blood Pressure? List medications:
Do you wear glasses or contact lenses?
Do you have Asthma?
Do you have Heart Disease? List medications:
Do you have Lung Disease? List medications:
Do you have Kidney Disease? List medications:
Do you have Liver Disease? List medications:

Have you ever had a severe neck injury? Describe:

Have you ever been knocked out? Describe:

Have you had a broken bone or fracture in the past 2 years? Describe:

Have you had knee pain in the past 2 years that has disabled you for longer than a week? Describe:

Have you ever injured your back? Describe:

Describe any current pain you may be experiencing: Describe:

Do you have other physical conditions which cause pain? Describe:

Have you had any surgical procedures: Describe:

What are your goals for the next three months? Describe:

Have you had your body fat tested? Describe testing and results:

Are you training for a specific event? If yes, explain:

I agree to all Terms and Conditions

captcha