Please fill out this registration form as complete as possible and submit with payment to:
TiF-FiT
14920 W Peppermill Dr.
Olathe KS 66062
Phone: 913-209-2690
Date: ______________________
Personal Information
Name
Phone, Day
Phone, Evening
Address
Street:
City: State: Zip:
Email
Preferd Contact
Day Phone / Evening Phone / Email
Gender
Male / Female
Date of Birth
Shirt Size
Emergency Contact 1
Name
Phone
Emergency Contact 2
Name
Phone
Medical Contact
Clinic/Physician
Phone
Camp & Class Information
Program
Start Date
Session
Fee
Please list some of your main Health/Fitness Goals.
What have been your obstacles in the past staying with a Fitness Program? (example: medical, family, lack of support, boredom, etc.)
Refunds will not be issued after acceptance of
registration. If TiF-FiT cancels a program due
to limited registration, a full refund will be issued within two to three
weeks. Completion of the registration form is required before attending
any TiF-FiT camp or program.
LIABILITY & MEDICAL RELEASE:
In consideration of
participation in TiF-FiT activity, participants,
parents and/or guardians acknowledge that they are aware of the nature of the
activity, and that there are inherent risks in any such activity, and release
TiF-FiT, owner Tiffany Jenks, and its
trainers/instructors from liability for any and all claim for personal
injuries, including injuries that arise from the negligence of someone other
than the participant. Participants, and or parents/guardians of a
registered minor, authorize trainers/instructors of TiF-FiT
to seek medical treatment in the event of an accident or emergency.
With your request to participate in a TiF-FiT
program, we request that you ask your doctor’s advice if you have a history
of heart trouble, diabetes, high blood pressure, or other medical problems prior
to participation in an exercise program. We also suggest that you have
a physical examination performed by your doctor prior to increasing physical
activity and participation in an exercise program.
