Cardio-kick, TRX, Boxing, Kettlebell & Boot Camp
(516) 694 - 1530

M.A.X. BOOT CAMP

Must be 14 years or older and anyone under 18 must be accompanied by a parent or guardian to complete registration form for the first time.

Please bring a valid State I.D. which is required to register-NO EXCEPTIONS. We do not do anything barefoot so please bring an extra pair of sneakers which you/your child can change into in our lobby. This way we keep the training floor clean of dirt and glass.

Please fill out the entire form. All fields must be filled out to attend the camp.
Private's First Name:
Private's Last Name:
Date of Birth: Month, Day, Year
Email:
Home Address:
City:
Zip code
Home phone:
Cell Phone:
How did you hear about us? Please Tell
If referred, please list their name here. First and last name.
Will you be living in the area for the next 12 months?	Yes No
Any medical info. we need to know?	Yes No
Have you ever taken a class with us Before?	Yes No
Select as many reasons for enrolling in BOOT Camp as are pertinent.	Confidence Weight loss Health Fun Toning Stress relief Discipline Self Defense
Pertinent medical info:
Short term goals
Long term goals

Any Martial Arts, Cardio kick and or boxing experience?	Yes No
Parents Information. Must have this info. for minor to participate.
Mom's Full Name
Mom's Cell Number
Dad's Full Name
Dad's Cell Number
Parents must come in to sign a release form the first time. We can not send it to you. Parents please bring valid I.D.

NOTICE:

M.A.X. Fitness urges all persons to obtain a physical examination from their physician prior to taking any Martial Arts or Fitness class. In recognition on the possible dangers connected with any physical activity, participant(s) hereby knowingly and voluntarily waive any right by filing this form to cause action of any kind whatsoever arising as the result of such activity from which any liability may or could occur to M.A.X. Fitness, its officers, employees or instructors. I give permission to the person listed to take class. I also give permission to M.A.X. Fitness to have myself or child taken to the hospital in case of an emergency.

1530 Old Country Road Plainview NY 11803
(516) 694-1530

GIFT CERTIFICATES AVAILABLE

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If you live in the following towns of Plainview, Melville, Dix Hills, Woodbury, Muttontown, Brookville,Syosset, Jericho, Greenlawn,Oyster Bay, Laurel Hollow, Farmingdale, East Farmingdale, South Farmingdale, West Hills, East Hills, Huntington, Huntington Station, South Huntington, Lindenhurst, Babylon, Bethpage, Old Bethpage, Carle Place, Mineola, Westbury, Garden City, Levittown, Hicksville, East Meadow, Lynbrook, Rockville Center, Valley Stream, Wyandanch, Wheatley Heights, Commack, Merrick, Wantagh, Bellemore, New Hyde Park, Salisbury, Massapequa, Massapequa Park, East Massapequa, Seaford, Amityville, Copiague, Williston Park, or Nassau County then you are close enough to come train with us!

Cardio-kick, TRX, Boxing, Kettlebell & Boot Camp (516) 694 - 1530

M.A.X. BOOT CAMP

NOTICE:

1530 Old Country Road Plainview NY 11803 (516) 694-1530

GIFT CERTIFICATES AVAILABLE

Cardio-kick, TRX, Boxing, Kettlebell & Boot Camp
(516) 694 - 1530

1530 Old Country Road Plainview NY 11803
(516) 694-1530