I, the undersigned, being aware of my own health and physical condition, and having knowledge that my participation in any exercise program may be injurious to my health, am voluntarily participating in a physical activity. Having such knowledge, I hereby acknowledge this release, Jason D Fitness and all business associates, affiliates, any representatives, coaches, agents, and successors from liability for accidental injury or illness which I may incur as a result of participating in the said physical activity. I hereby assume all risks connected therewith and consent to participate in said program. I agree to disclose any physical limitations, disabilities, ailments, or impairments which may affect my ability to participate in said fitness program. *

I understand and agree to the liability waiver.

Name *

First Name

Last Name

Phone Number *

Country

(###)

###

####

Company/Group Name *

GovGuam

Federal

Judiciary of Guam

Checkbox *

Subscriber

Dependent

Date of Birth *

MM

DD

YYYY

Camp Location (you may choose more than one) *

Tamuning

Dededo AM

MongMong-Toto-Maite

Hagat

Mangilao

Glute - Cardio - Core Camp (MTM)

Would you like Dr. Ron to contact you for your FREE online introductory Health Consultation? (Approx 15 min) *

Take the first step towards better health and weight loss with a personalized consultation designed to address your specific needs and goals. Dr. Ron will guide you through this informative session, offering expert advice and insights to help you embark on your wellness and weight loss journey.

Yes

No