Registration Information

Simply Fit Bootcamp

Call Jen Today!
Simply Fit Bootcamp
(859) 221-7864
or Email: jenbrooks@insightbb.com

Please read the following information closely. Should you have additional questions, please feel free to email or call me!

                                     REGISTRATION

Returning Participants
Please complete the Returning Participant Form, all other forms are not necessary unless any information has changed. There are 2 links to this form, excel file and pdf file. Please email or mail the form to me. Follow payment instructions below listed under the "First Time Participant" section.

Returning Participant.xls

First Time Participant
Please fill out the registration forms below if you are a first time participant. Registration forms include Participant Contact Information, Release of Liability Form, and Health Questionnaire. After completing the registration forms, please follow the payment instructions. I accept cash, check, or you can pay via credit card through Paypal.

Package Options:
Option 1: $75 for 8 classes during 4 week session.
Option 2: $40 for 4 classes to use at your discretion during the 4 week session.

Check or Cash Payments: Please make checks payable to Southern Hills United Methodist Church and mail payment along with registration forms to the following:

Jennifer Brooks
960 Sunny Slope Trace
Lexington, KY 40514

Paypal Payments: To make payment using Paypal, please select your Package Option and then click the Paypal "Buy Now" button below. This will direct you to Paypal. Follow all of Paypals instructions for completing payment.  Please send all registration forms via email or postal mail (address listed above) before the first day of camp. If you have any questions, please feel free to contact me.

Paypal Information:

Click on the following links to access the registration forms.

Participant Contact Information
Release of Liability Form

Health History Questionnaire: Complete form below. Once completed, click the "submit" button and the health history questionnaire will be emailed directly to me. This information will be held in confidence and will not be discussed with anyone.

Health History Questionnaire

Please complete the following health history questionnaire. Please answer the questions fully. The health history questionnaire will allow me to better assess your situation and create a bootcamp to better adapt to your health requirements. Once completed, please click on the submit button at the bottom of this form.

Participant Name:
Participant Age:
Participant Email Address:
Do you have any personal history of pulmonary disease or asthma?:
Do you have any personal history of diabetes?:
Do you have any personal history of arthritis?:
Have you experienced any pain or discomfort in your chest?:
Have you experienced shortness of breath?:
Have you had any problems with dizziness or fainting?:
Do you have any swelling of the ankles?:
Do you have any pain in your leg muscles while walking?:
Do you have any personal history of heart disease?:
Do you have any known heart murmur?:
Has your cholesterol been measured any greater than 200?:
Are you a cigarette smoker?:
Would you characterize your life as sedentary?:
Are you 20% or more overweight?:
Are you being treated currently for high blood pressure?:
Have you been assessed with high blood pressure?:
Are you pregnant or have you had a baby in the past three months?:
Have you had surgery in the past three months?:
Have you recently had a physical by your general doctor?:
Has your doctor imposed any activity restrictions? If so, please describe.:
Do you have any back problems, knee problems, shoulder problems, foot problems, recent joint pain, recent surgery, a hernia, asthma, or any other condition that would be helpful to know before you start this exercise program?:
Please review all answers above. It is important that this information be accurate and complete as possible. Once reviewed, please click on the submit button below. This questionnaire will be emailed directly to me. Your information will be held in complete confidence.