Many health conditions can make exercise unsafe. It's especially important to talk to your doctor if:

• You've been inactive for more than six months.
• You're a man age 40 or older, or a woman age 50 or older, and you haven't had a physical examination within the past two years.
• You've ever had a heart attack, or you have cardiovascular disease, high blood pressure or diabetes.
• Anyone in your family has died of cardiovascular disease before age 50.
• You take medications or follow a special diet to improve your cholesterol levels.
• You take medication to manage a chronic condition.
• You smoke, or you have emphysema, asthma, allergies or any other lung condition.
• You have a chronic condition, such as arthritis that limits your flexibility, strength or endurance.
• You're pregnant.
• You have noticeable pain in a particular joint or muscle when walking or participating in any type of physical activity.
• You've previously experienced a joint or muscle injury for which you haven't received formal treatment, or for which you continue to have persistent symptoms.
• You've been inactive for more than six months

Registration Form

Full Name:
Nick Name:
Home Address:
Home Phone:
Mobile Phone:
Email Address:
Birthday (MM/DD/YYYY):
Emergency Contact:
Emergency Contact Phone:
Known Medical Condition:
Known Allergies:
Current Medications:
How many days a week do you excercise?:	One Two Three Four Five Six Seven
How many minutes of excercise do you average?:
Select the statement that best describes your plans for exercise I don't plan to exercise more within the next six months. I am thinking about exercising more within the next six months. I am making plans to exercise more within the next 30 days. I am actively trying to exercise more or have increased my exercise level within the past six months. I exercise on a regular basis and have done so for more than six months.
Choose your primary barrier to exercise I don’t have enough time to exercise regularly. Exercise is boring. I don’t like to do the same thing day after day. My family and friends don’t support my efforts to exercise regularly. I’m afraid I’ll hurt myself if I exercise. I’m self-conscious about the way that I look when I exercise. I’m too lazy to exercise. I’m too tired to exercise after working all day. I’m not athletic. I’ve tried to exercise regularly in the past and failed. I can’t afford to buy fancy exercise equipment or join a health club. I don’t have a convenient place to exercise. None
How confident are you in your ability to excercise on a regular basis? Not at all confident Somewhat confident Moderately confident Very confident Completely confident
What is your primary reason for joining this program? I’m not currently active, and I want to get moving! I want to exercise more consistently. I want to lose weight. I want to maintain my current weight. I want to take my fitness to the next level. Other (please specify below).
Other Goals:
Registration For:	Boot Camp Individual Training Other