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Contact Information (required)

Full Name
Mailing Address
City
Postal Code
Home Phone
Work Phone
Cell Phone
Date Of Birth
E-Mail Address
I am a:
      Returning Member

Choose Your Program (required or customize your program in the next section)

Four (4) Week Session Memberships

Two (2) Days Per Week
For Four (4) Weeks =
Eight (8) classes per session

Three (3) Days Per Week
for Four (4) Weeks =
12 classes per session
One (1) Session Membership

$155 + GST ($7.75) =
$162.75 per session

$215 + GST ($10.75) =
$225.75 per session

Three (3) Consecutive Sessions Membership
(!!! See the note below !!!)


$140 + GST ($7.00) =
$147.00 per session
($45 total savings!)


$195 + GST ($9.75) =
$204.75 per session
($60 total savings!)

Six (6) Consecutive Sessions Membership
(!!! See the note below !!!)


$130 + GST ($6.50) =
$136.50 per session
($150 total savings!!)

$180 + GST ($9.00) =
$189.00 per session
($210 total savings!!)

** FULL YEAR PROGRAM **
Ten (10) Consecutive Sessions Membership
(!!! See the note below !!!)


$120 + GST ($6.00) =
$126.00 per session
($350 total savings!!!)


$170 + GST ($8.50) =
$178.50 per session
($450 total savings!!!)

!!! NOTE !!! When registering for three or more consecutive sessions, your first session will be billed immediately. You will then be billed automatically monthly. You're "Recurring Billing" will be for 2 recurring charges (for a 3 session membership), 5 recurring charges (for a 6 session membership), or 9 recurring charges (for a 10 session membership). Recurring billing can only be done on credit card.

Choose Your Starting Session

June 2 - June 27, 2008 July 7 - Aug 1, 2008
Aug 11 - Sept 5, 2008 Sept 15 - Oct 10, 2008 Oct 20 - Nov 14, 2008
Nov 24 - Dec 19, 2008 Jan 5 - Jan 30, 2009 Feb 9 - Mar 6, 2009

Choose Your Location

Etobicoke Central - Tuesday & Thursday
St. Wilfrid’s Church
1315 Kipling Ave, Etobicoke
6:00AM - Tue, Thu
6:15PM - Tue, Thu
7:30PM - Tue, Thu
Etobicoke South - Monday, Wednesday, Friday
Franklin Horner Community Centre
432 Horner Avenue, Etobicoke
6:00AM - Mon, Wed, Fri
High Park - Monday, Wednesday, Friday
Bloor St W & High Park Ave Entrance

6:00AM - Mon, Wed (not available for Apr 28 session)
6:30PM - Mon, Wed, Fri
7:30PM - Mon, Wed


Custom Program - Choose Your Plan

Custom 2 Day Membership
Custom 3 Day Membership
Custom 5 Day Membership


$155 + GST ($7.75) = $162.75


$215 + GST ($10.75) = $225.75

$280 + GST ($14.00) = $294.00

Custom Program - Choose Your Days

 
Monday
Tuesday
Wednesday
Thursday
Friday
Etobicoke Central     6:00AM
6:15PM
7:30PM
 
Etobicoke South 6:00AM   6:00AM   6:00AM
High Park / Bloor West 6:00AM
6:30PM
7:30PM
  6:00AM
6:30PM
7:30PM
  6:30PM

Please note that the High Park Friday 6:30PM Custom Program and High Park 6:00AM Classes are NO LONGER an available option for the April 28th session.


Fitness Equipment

Equipment needed: Yoga Mat, Exercise Ball, and Hand Weights.
(5 lbs weights for women and 7/8 lbs weights for men is suggested).

These items may be purchased from Body Buster Fitness, and can be picked up at your first class.

All other equipment will be supplied by Body Buster Fitness during class.

Item Qty
Hand Weights - 5 lbs (women) - $7.50 each 2 x $7.50 = $15.00 + tax
Hand Weights - 7 lbs (men) - $10.00 each 2 x $10.00 = $20.00 + tax
Exercise Ball - $22.50 $22.50 + tax
Ball Pump - $4 $4.00 + tax
Exercise Mat - $22.50 $22.50 + tax
Mesh Carry Bag for Exercise Mat - $10 $10.00 + tax

Boot Camp Bundle - Save 16.5%!
Includes Exercise Mat, Hand Weights, and Exercise Ball

5lbs Bundle - $50.00 + tax
7lbs Bundle - $55.00 + tax
*A receipt will be sent to your email address. You may pick up any equipment ordered at your first fitness boot camp class.

Promotion

Promotion My Friend(s)
Sign up with some friends, and earn discounts, credits, and extra classes!

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Emergency Contact Information (required for new registrants)

Name Of Physician
Phone Number
 
Emergency Contact
Name
Relationship
Primary Phone
Secondary Phone

More About You (required for new registrants)

How did you hear of Body Buster Fitness' BOOT CAMP classes?
What are your fitness goals during BOOT CAMP?
Have you ever taken a BOOT CAMP CLASS before? Yes No
If yes, please explain:
Are you currently involved in any physical activity? Yes No
If yes, please explain:
How would you rate your current fitness level from 1 (sedentary) to 10 (very fit)?

Health Questions (required for new registrants)

Do you have any past or present injuries? Yes No
If yes, please explain:
Do you know of any reason why you should NOT do physical activity? Yes No
If yes, please explain:
Do you have a heart condition or other condition that may cause challenges while doing physical fitness activities? Yes No
If yes, please explain:

Please note that it is a good idea to consult your physician before starting any new fitness program. Be sure to pace yourself in regards to your current fitness level and remember to have fun!

It is also a good idea to ensure that you are getting an adequate amount of water especially when adding fitness into your daily lifestyle.

Please note that you will be asked to sign a waiver form at the first day of class.


Pre-existing Conditions (required for new registrants)

Do you have any of the following:    
Anemia Yes     No Hypertension Yes     No
Asthma Yes     No Diabetes Yes     No
Epilepsy Yes     No Back Pain Yes     No
Neck Pain Yes     No Arthritis Yes     No
Cancer Yes     No Joint Pain Yes     No
Recent Surgeries Yes     No    
If you answered yes to any of the above, please explain:
Please list any medications you are currently taking:

Body Buster Fitness Boot Camp Liability Waiver

All prices listed are in Canadian dollars.

I understand that my absent days are not carried forward to another Boot Camp session but I may make them up during the same session but at an alternate time. Limited to two makeup classes per session based on Body Buster approval.

I understand that there may be photos / video footage taken that may be used for marketing / advertising.

I understand that there are no refunds but I may carry over my contract with a note from a physician stating if I am no longer able to continue the Body Buster Fitness Boot Camp program with the notion that I would return when the physician sees appropriate.

I understand that all activities involved with the Body Buster Fitness Boot Camp program may be an extreme challenge to my physical and mental abilities. I hereby certify that I am fit to participate in any and all such activities and that such determination has been made by a qualified medical professional.

I understand that activities involved in the fitness program carry with them the potential of harm to myself, my property, loss or damage to my possessions, bodily injury and death. I hereby certify that I understand and accept all risks associated with my participation in Body Buster Fitness Boot Camp and agree to hold harmless it’s management, staff, or associated person(s) and/or entities from and against any and all liability for any harm to myself or my property that may arise from my participation in this program.

I understand that I must be aware of my physical conditions/limits and that there are risks associated with fitness training activities. Also, I understand that I am encouraged to get a regular medical examination prior to participating in the Fitness Boot Camp program.

The schedule, location, or content of workouts may be changed on occasion due to circumstances beyond the control of Body Buster Fitness.

Body Buster Fitness Boot Camp membership payments are non-refundable.

I understand that in order for me to take advantage of reduced session pricing offered by Body Buster Inc., for multi-session packages of one of 3, 6 or 10 consecutive session, I must commit to pay Body Buster Inc. by monthly installment payments for the multi-session package I select.

I agree to have Body Buster Inc. charge may credit card on a consecutive monthly basis starting with the day I sign up and continuing for each and every month that follows up to a total number monthly charges to my credit card equal to the number of sessions set out in may package. (For example, if I sign up for 3 consecutive sessions Body Buster Inc. shall charge my credit card the lower session pricing on the day I sign up and on the same day in the next two months).

I understand that the monthly charge to my credit card is determined by the day of sign up and does not correspond to the actual starting dates for the session for which I have signed on.

I certify that I have read and fully understand the waiver, liability,
and policies and fully agree to abide by the conditions and terms stated above.

Best phone number to reach you:

   

You MUST confirm you have read the liability waiver above before being allowed to submit this form.

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