Bonus

It's Michael Andreula with a PS:

Part of the success of every previous ReBoot Camp Retreat is
the goal-setting and "lead up" that occur prior to getting on the plane...

If you reserve your spot today, I will include
4 complimentary personal training sessions in the weeks before
we leave for Costa Rica. Along with training, we will go over your
current fitness and nutrition plan, and set goals for 2014. We will discuss how to get you running at your optimum level, and ensure that THIS year, you not only reach-- but actually exceed-- your health and fitness goals!

"ReBoot Camp Invite"

Please complete the registration and health information form below, if you have not done so already.

* Indicates required field

I am a...* *

Name *

First

Last

Email *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Phone Number *

Emergency Contact Information

Contact Name *

First

Last

Phone Number *

Contact Name *

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

Do you have any medical condition we should be aware of? *

No Yes

Do you have any injuries we should be aware of? *

No Yes

Are you allergic to any medication (aspirin, penicillin, sulfa, etc)? *

No Yes

Do you regularly take any prescription medications? *

Do you have any injuries? *

Personal Information

Height *

Weight *

Needed if you want to surf, race cars, equipment, paddleboard and/or kayak

T-Shirt Size *

ReBoot Camp Retreat Questionnaire

Would you like to take *

Spanish Lessons Surf School Massage On The Beach

Other *

Fitness/Goal Information

Describe Your Fitness: Include the activities in which you participate (e.g. running, hiking, walking, biking, skiing, aerobics, swimming, yoga, pilates, etc.), the frequency with which you participate in each activitiy (i.e. how often, how far, for how long), the duration of your fitness program, and any other information you woud like us to have. *

Your Intention! What do you hope to accomplish and/or learn at the retreat? *

Describe your intentions, goals, and wild visions for the retreat!* *

Is there any activity that you are particularly eager to experience at this retreat? *

Do you have any questions or concerns? *

Please call us if you'd like to discuss any questions or concerns. Is there anything else you would like us to know about you? *

How did you hear about ReBoot Camp Retreats?? *

Submit