Returning Boot Campers Registration

Name	* required
Cell Phone	* required
Emergency contact name and number:
Home Phone
Address
Email Address
Date of Birth
Camp date you are registering for:	January 18 - February 5 (3 week camp) February 15 - March 12 March 22 - April 16 April 26 - May 21 May 31 - June 25 July 5 - July 30 August 9 - September 3 September 13 - October 8 October 18 - November 12 November 15, 17, 19 - FREE November 29 - December 17 (Three Week Camp)
How many days/week will you be attending?	3 days $199 4 days $250 5 days $299
Payment & Day Selection for our Summer Blues Boot Camp Special:	This option only applies for the July 5th and August 9th Boot Camps:  a.k.a. Summer Blues Boot Camp Special! Does Not Apply 3 days/ 99.50 4 days/$125.00 5 days/ $149.50
What is your main goal?
What location are you registering to attend?	Centennial Park: 5:15am (women only) Silver Lake: 3 day -5:00am M -W & Sat. 6:00am) Silver Lake: 6:00pm (Co-Ed: 3 day option only-M- W - Th)
Are you planning to attend the FREE nutrition lecture the first Monday evening of boot camp?	Yes No
PAYMENT: Space is limited.  To reserve your spot send in payment immediately.	Paying online with credit card (After submitting this form, return to Payment tab to pay.) Mailing in a check (Make check payable to Vince Garcia)