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fitness camp main | letter from mike | itinerary & details Mike Francois Fitness Camp Registration Form To register: Print registration form, complete, and mail to the address below. Name:_____________________________________________________________________________________ Address: ___________________________________________________________________________________ Phone (Home):_______________________________ Phone (Work):___________________________________ E-Mail:______________________________ Sex: Male____ Female____ Date of Birth:____________________ Height:______ Weight:________ Fitness Level (Beginner, Intermediate, Advanced)_______________________ 1)
When would you like to attend the Mike Francois Fitness Camp? ____
/____ /____ - ____ /____ /____ 2) Please list an alternate 3-day weekend time frame: ____ /____ /____ - ____ /____ /____ 3) Would you be interested in having Eric Serrano, M.D. analyze your blood work to determine if you are over training, what your testosterone level is, if you have any mineral deficiencies, etc.? (Note: There is an additional fee for this service. Please e-mail us for details). Yes ______No _______ 4) Will you be attending by yourself? Yes ______No _______ If no, please list the name of the person that will be attending the camp with you:________________________________________________ (Note: This is for cross referencing only. Each individual needs to complete a registration form).
PRICE: $650.00 (U.S.) per person OR bring a friend and pay only $500 each! (Note: If you answered 'Yes' to question 3, please e-mail us regarding additional fee before submitting registration). DEPOSIT: A 50% deposit is due with your registration. The balance must be received four (4) weeks prior to your scheduled visit. The deposit is refundable up until four (4) weeks prior to your scheduled visit. METHOD OF PAYMENT: Checks (if drawn on accounts within the U.S.), money orders, cashiers checks, and credit cards (VISA, Master Card, American Express) are accepted. If you are paying by credit card, please complete the information below. All information will be held in strict confidence. VISA Master Card Am Express Name on credit card:_________________________________________ Credit Card #:______________________________________________Expiration Date:____________________ Signature:_______________________________________________________ Date:_______________________ Note: Signature required for all registrants. Mail your completed
registration to: Mike Francois Fitness Camp, P.O. Box 26752, Columbus,
OH 43226. |
