How did you hear about this program?
What are your goals during this program?
If you've ever particpated in a program like this before, please give details:
Are you currently involved with any fitness program or physical activity?
How would you rate your current fitness level?
Please give details of any past or present injuries, or medical conditions (state NONE if none):
Please give details of ANY potential reason you should NOT participate in a physical fitness program (state NONE if none):
Please give details if you have a heart condition or any other condition that may cause challenges while participating in physical fitness activities (state NONE if none):
Do you have any of the following: Anemia, Hypertension, Joint Pain, Epilepsy, Asthma, Diabetes, Back Pain, Recent Surgery, Arthritis, Cancer, Neck Pain? If so, please give details. (state NONE if none)
Please list any current medications you are taking:
Additional Comments:
Program Information
Terms & Conditions
All prices listed are in Canadian dollars.
Body Buster, Body Buster Inc., Body Buster Personal Training, Body Buster Nutrition, Body Buster Nutrition and Wellness Program, Body Buster Bootcamp, Body Buster Boot Camp, Body Buster Fitness, Body Buster Fitness Bootcamp, and Body Buster Fitness Boot Camp, Body Buster Nutrition, Body Buster Nutrition and Wellness are herein referred to as Body Buster.
I understand that Body Buster memberships are nontransferable.
I understand that all Body Buster purchases (including, but not limited to, membership payments, programs, classes, merchandise, equipment, clothing, and products) are non-refundable.
I understand that missed classes, sessions, meeting, and/or workshops are not, will not, and cannot be carried forward to another Body Buster program.
I understand that while participating in any Body Buster program, workshop, and/or class, photos, video, and/or audio may be captured/recorded for the purpose of marketing/advertising, and that I authorize Body Buster to use any and all photos, video, and/or audio of me for those purposes of marketing/advertising without compensation.
I understand that if I am unable to complete the Body Buster program due to a medical condition, I may be allowed to defer a portion of my current program to a future program, conditional on providing documentation from a physician* stating that I cannot complete the current program.
I understand that if I defer a portion of my program due to a medical condition, I cannot return to the program until I provide documentation from a physician* stating that I am fit to do so.
I understand that all activities involved with the Body Buster program may be challenging to my physical and mental abilities, and I hereby certify that I am fit to participate in any and all such activities and that such determination has been made by a physician*.
*The term physician refers to any medical doctor or specialist licensed to practice medicine in Ontario, and who is certified and registered in good standing with The College of Physicians and Surgeons of Ontario.
I understand that the Body Buster program involves activities that carry with them the potential of harm to myself, my property, loss or damage to my possessions, bodily injury and death, and I hereby certify that I understand and accept all risks associated with my participation in the Body Buster program and agree to hold harmless its management, staff, 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 the Body Buster program.
I understand that I must be aware of my physical conditions/limits and that there are risks associated with all Body Buster activities.
I understand that the schedule, location, or content of the workshop or program may be changed due to circumstances beyond the control of Body Buster.
I understand that to qualify for the reduced pricing of a multi-program package, I must enroll in a complete multi-program package , and agree to pay Body Buster by monthly installment payments for the multi-program package I have enrolled in.
I understand that to qualify for enrollment in a multi-program package, I must complete the online registration form for the appropriate program, and pay via credit card, and that that same credit card will be used for the duration of the contract.
I understand that to qualify for the reduced pricing of a small-group package, I must enroll with other members, and that their continued adherence to these terms and conditions is required to qualify for small-group pricing.
I agree to allow Body Buster and/or any agents working on behalf of Body Buster to charge my 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 of monthly charges to my credit card equal to the number of programs set out in my multi-program package.
I understand that for multi-program packages, the monthly charge to my credit card is determined by the day of enrollment, and does not correspond to the actual starting dates for the program for which I am enrolled.
SUBMIT
By submitting this form, you acknowledge you have read and agree to the stated terms and conditions.
A Body Buster Representative will contact you after we receive your registration form to confirm all details.
