2012 CAMP DATES:

Jan. 2 – Jan. 27
Feb. 6 – March 2
(No class Feb. 20)
March 12 – April 6
April 16 - May 11
May 21 – June 15
(No class May 28)
June 25 - July 20
(No class July 4)
July 30 – August 24
Sept. 10 – Oct. 5
Oct. 15 - Nov. 9
Nov. 19 - Dec. 21
(No class Nov. 22 & 23)

maine boot camp

Online Registration Form

Register Online in 2 Easy Steps!

To register for Maine Boot Camp, please complete the following on-line registration form and then select your method of payment. (Please note a credit card transaction will be applied for all Paypal transactions)

CAMP INFORMATION (*indicates required field)
Full Name*
Email Address*
What camp/location and dates are you registering for?*
How often will you attend?*
How many CONSECUTIVE camps have you attended?*
Form of payment:*
Pay via Paypal. 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.
I rate my current fitness level as a (1-10), 10 being high.*
Please list your goals for this camp session:
Are you training for a specific event? If yes, please list:
Are you a NEW camper or RETURNING camper?* New Camper       Returning Camper 
PERSONAL INFORMATION & MEDICAL HISTORY UPDATES (*indicates required field)
Has there been any changes to your personal or medical information since the last camp you attended?* No       Yes 
PERSONAL INFORMATION (*indicates required field)
Address* City*
State */ ZIP* / Profession*
Phone Number* Date of Birth* (mm/dd/yyyy)
Name of Emergency Contact & Phone Number*   
How did you hear about us?
Please specify (publication, search engine, friend, other referral)
Medical History (*indicates required field)
1. Are you allergic to any medication (aspirin, penicillin, sulfa, etc.)?* No       Yes 
List Medications:
2. Do you take any prescribed medication on a permanent or
semi-permanent basis?*		 No       Yes 
List Medications:
3. Do you have or have you ever had the following diseases?  
*Heart Disease: No       Yes 
*Hypertension/High Blood Pressure: No       Yes 
*Lung Disease: No       Yes 
*Asthma: No       Yes 
*Kidney Disease: No       Yes 
*Seizure Disorder/Epilepsy: No       Yes 
*Diabetes: No       Yes 
*Liver Disease: No       Yes 
4. Have you ever had a serious neck injury? If yes, describe:
5. Have you had a broken bone or surgery in the past 2 years?
If yes describe:
6. Have you ever injured your back and/or had back pain that made it difficult to exercise? If yes, describe:
7. Have you ever had a knee injury and/or knee pain that made it difficult to exercise? If yes, describe:
8. Do you have any other conditions or ailments that may
limit your physical activity? If yes, describe:
9. Do you current participate in a regular exercise routine?
Describe frequency and type of activity.
Maine Boot Camp Agreement
I agree not to use foul language during Boot Camp. Any violation will result in twenty push-ups per occurrence.
I agree not to eat or say the words Cake, Cookies, Whoopie Pies, or Donuts during the course of Boot Camp. Any violation will result in twenty push-ups per occurrence.
I agree to show up for Boot Camp every day unless it is an excused absence from my doctor or pre-approved with my Boot Camp trainer. Any violation will result in twenty push-ups per occurrence.
I understand that photos or video may be taken during the course of my involvement in Boot Camp, which may be used for promotional purposes.
I understand there is no refund policy, but I may receive a credit (for an unused portion of camp) towards a future camp if I'm not able to complete the one I originally joined. Camp fees cannot be used towards any other products or services provided by Maine Boot Camp. ** Credits are issued on a case-by-case basis and are done so as the sole discretion of Maine Boot Camp.
I agree that I am fully committed to this program for its full duration and will remember to set my alarm and be at camp on time. Any violation or TARDINESS will result in twenty push-ups per occurrence.
I understand that diet and nutrition will effect my fitness goals and performance during boot camp. (if your weight loss goals exceed 20 lbs., it is the recommendation of Maine Boot Camp to participate in one of the adjunct nutrition programs offered to establish appropriate and safe nutritional strategies).
I will bring a positive attitude, and expect to have fun each day I am in attendance at Maine Boot Camp.
Maine Boot Camp Release

NOTICE: It is wise to seek your doctor's advice before beginning any health/fitness/nutrition program!

This release is entered into between the undersigned and Maine Boot Camp, its officers, subsidiaries, affiliates, and executors in addition to the Cape Elizabeth School Department and Cheverus High School. The purpose of Maine Boot Camp is to provide fitness 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:

1. I understand the risks associated with participation in the above listed activity. I hereby agree to release discharge, indemnify and hold Maine Boot Camp and their trainers, agents, and employees, the Cape Elizabeth School Dept. and their agents and employees, and Cheverus High School and their agents and employees harmless from any liability claims, demand costs or damages arising out of said program activity which I might sustain during participation. I have read this document carefully and sign it voluntarily with full knowledge of its significance.

2. Acknowledges that Maine Boot Camp trainers are not physicians and are not trained in any way to provide medical diagnosis, medical treatment, or any other type of medical advice in relation to one's participation in camp.

3. Acknowledges that coaching/training is another tool for teaching athletes/individuals about themselves, but that Maine Boot Camp does not guarantee neither good nor bad will occur nor guarantees the training advice given by Maine Boot Camp's trainers will produce good nor bad results.

4. 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 notify his or her Maine Boot Camp trainer, cease participation in the program and contact a physician at once.

5. 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 elements of a natural environment, 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 Maine Boot Camp and their trainers, agents, and employees, the Cape Elizabeth School Dept. and their agents and employees, and Cheverus High School for the undersigned participating in said sporting events and/or training for said program and activities.

The Undersigned agrees that this is the full agreement between the parties, that Maine Boot Camp including its trainers 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.
Agreement and Signature (*indicates required field)
I agree to all Terms and Conditions listed above*
Electronic Signature*
Date (MM/DD/YYYY)*