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Contact Number: (203)450-6755



E-mail: Neville@Fitkids-program.com



REGISTRATION FORM



Return form with payment to:



Fit Kids Program: 963 Wells Place Stratford Ct, 06615

Name____________________________________________________



Address___________________________________________________



City_______________________________State___________________



Home Phone______________________Cell______________________



Emer Phone______________________ E-mail____________________



Age______ T-shirt size____________





CHECK SESSION(S) OF INTEREST:



AUGUST 8-12 ( ) AUGUST 15-19 ( )



WAIVER: I hereby authorize the staff of Fit Kids to act for me

according to their best judgment in any emergency requiring medical

attention for my child, if I cannot be contacted.



In consideration of acceptance of my child. I hereby for myself, my @

child, their heirs, executors and administrators hold harmless, waive

and release any claim we may have for damages against the above

mentioned organizations, camp operators, their officials, officers, Greenwich Country Day School

employers or representatives, or their successors and assigns for any

or all injuries that may be suffered. I certify that I am 401 Old Church Road

parent/guardian of: ____________________________________And

I am over the age of 18 years. I further agree that the above named Greenwich, Ct 06836

parties are under the obligation to provide a physical examination or

other evidence of a Childs fitness to participate in this program, the

same being my sole responsibility.

(203)450-6755

SIGNATURE OF PARENT/GUARDIAN ________________________

*Partial scholarships available, please contact us

FOR BOYS & GIRLS

DATE_________

directly.

I attest that my child is in sound condition to participate in all 8 YRS TO 14 YRS

activities. I understand by signing this waiver any or all

refunds will come in the form of program credit. 1 week sessions from



www.fitkids-program.com Aug 8, 2011 to Aug 19, 2011

When: One week Sessions from

August 8, 2011 to August 19, 2011



All sessions will be:

Days Hours

The “Fit Kids Program” is a summer fitness Monday- Friday 10 AM-2 PM

fundamentals program designed to challenge kids

ages 8 to 14 to learn the basics of conditioning,

1 Session 2 Sessions

strength, safety skills, good nutritional habits and $295.00 $590.00

self confidence. Our goal is to teach kids, through

positive reinforcement, the fun of a fitness Facilities include:

lifestyle that will carry them through and beyond

their high school careers. For us to preserve the · 2 pools (with certified life guards on duty)

uniqueness of our program and the safety of your A $25.00 Registration Fee must be added.

child (ren), we will provide (8) to (1) ratios.

· 3+ fields 10% discount for each additional family member



Who we are;

· Baseball diamond

Neville Warburton,BS,CPT

Bobby Argiro-Bevilacqua,BS,CPT

Program fee includes:

Chris Gradilone,BS,CPT

· Basketball courts in/outdoor

· "Fit Kids" T shirt



· Fitness center - weight room/ cardio room

· Gatorade and water throughout the day

Attendees must bring:

· Fresh fruit snacks

This program will be run by highly qualified · Lunch

professional personal trainers with 20 years of

combined experience along with a closely

· Swimsuit

supervised staff. The extent of our combined

knowledge and experience is invaluable. We will

be sure that your child walks away from this · Towel

program feeling accomplished and driven, with

the courage to succeed in their sport of choice, or

motivated to continue with a positive, healthy

· Sunscreen

lifestyle.

· Must wear sneakers (no flip flops)



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