Strength Camp Application

Dear Applicant,
Be sure to read and complete this application in its entirety. Incomplete applications will
NOT be accepted and your admission into Strength Camp may be compromised. Your
answers to these questions will be used to determine your eligibility for admittance into
any of our Strength Camp programs. Parents of athletes under the age of 18, please
compete this application in it entirety with your child.
Strength Camp is a fitness camp and athletic strength-training program designed to
challenge members physically, mentally and emotionally. The programs are designed to
support members in the achievement of Fat Loss, Muscle Strength, Flexibility,
Endurance, Stamina, Athletic Capacity and Character.
This is accomplished through the completion vigorous exercise routines which may
include sprinting, jumping, bounding, lifting heavy sandbags, flipping tractor tires,
pushing cars or trucks, dragging sleds, bodyweight squats, lunges, push ups, chin ups,
etc. The exercises are challenging but do-able.
NOTE: Not every applicant is accepted into Strength Camp. In order tomaintain the
integrity of the exercise programs, quality of service and reputation for results we
must be diligent about our screening process.
The best applicants are not always the most fit! ATTITUDE accounts for 99% of
theresults you will receive. Wehave had members that weigh over 350 lbs with an
extraordinary attitude; we have had members with severe injuries to the knees, neck,
back and shoulders accomplish their goals because of an uncompromising attitude.
We are NOT in the business of only serving those who are genetically gifted with
physical strength and endurance. We ARE in the business of serving individuals who are
committed to achieving their lifes potential and purpose.
The fact that you have read this far, meansthat you are in a class above most people,
you are in the winners circle. You are ready to take action in your life - beginning
with your health, strength and physical fitness.
It is my firm conviction that your mental capacity and spirit are reflectedin your physical
body. A strong physical constitution allows for greater clarity and achievement in ALL areas
of your life. It is upon this holistic approach that Strength Camp was founded.
Whether you are a high school football player, fireman, corporate executive or home
maker, you will discover that Strength Camp will challenge you and elicit growth
that will be evident in your daily performance and at play.
Good Luck,
Elliott Hulse CSCS The Strength Coach
Name______________________________
E-Mail _________________________________
Address____________________________
DOB___________________________________
Your Phone___________________________
Emergency Contact________________________
City / State, Zip______________________
Their Phone______________________________
Occupation__________________________
Elliott Hulse Inc. (Strength Camp)
I __________________________________ have agreed to participate in Strength
Camps fitness service, an indoor and outdoor fitness camp. The activities of Strength
Camp include strength training, running, agility drills, jumping, intense cardiovascular
activities and flexibility training. Acknowledgment is hereby made that the activities of
the camp will require me to spend time outside in the heat, as well as inside. I further
acknowledge that there are risks involved in participating in the strength camp. The risks
include, but are not limited to, those caused by terrain, facilities, temperature, weather,
my physical condition, equipment, actions of other people including, but not limited to,
participants, volunteers, and lack of hydration.
In consideration of my being accepted into the program, I agree to release and discharge
Strength Camps and any of its employees, volunteers, coaches and supervisors, The City
Of St.Petersburg, Elliott Hulse Inc., Elliott Hulse, owner of the facilities, from any
injuries sustained by me as a result of participation in this program. I agree to indemnify
and hold harmless, Strength Camp, and any of its employees, volunteers and supervisors,
facilities and owners of the facilities against any liability incurred as a result of such
injury or loss. Fitness activities and programs require that I be in good health and have no
condition that could endanger my well being through participation. I will notify Strength
Camp of any such defects in writing prior to enrolling in this program.
The undersigned agrees to save and hold harmless and indemnify each and all of the
parties referred to above from all liability, loss, cost, claim or damage whatsoever which
may be imposed upon said parties because of any defect in or lack of such capacity to so
act and release said parties on behalf of myself.
Signature of participant__________________________________________
Parent if under 18 yrs old________________________________________
Date_______________
1. Medical History and Present Medical Condition
Check any of the conditions described below which you have, or have had in the past.
? Coronary Heart Disease
? Diabetes (Type 1 or 2)
? Stroke
? Peripheral Vascular Disease
? Phlebitis or Emboli
? Rheumatic Fever
? High Blood Pressure
? Low Blood Pressure
? Chest Pain or Discomfort
? Heart Murmur
? Ankle Swellings
? Migraines
? Swollen, Stiff, or Painful J oints
? Foot Problems
? Back Problems
? Neck Problems
? Fractures or Broken Bones
? Cold Hands or Feet
? Light-headedness or Fainting
? Epilepsy or Seizures
? Anemia
? Asthma
? Emphysema
? Bronchitis
? Pneumonia
? Ulcers
? Hernia
? Arthritis
? Bursitis
? Stomach or Intestinal Problems
? Osteoporosis
? Allergies
If you checked any of the above, please explain here.
List any prescribed medications you are taking.
List any over the counter medications or dietary supplements that you are taking.
List any illnesses, hospitalizations, or surgical procedures within the past 2 years.
2. Health and Fitness History
If you were involved in exercise or sports in the past, please describe the activity,
its intensity and duration.
How would you describe yourself today? (Circle one)
Sedentary/Inactive Lightly Active Moderately active Highly Active
How would you describe your nutrition habits? (Circle one)
Poor Fair Good Excellent
Describe your knowledge of exercise and fitness. (Circle one)
Poor Fair Good Excellent
Describe you knowledge of nutrition. (Circle one)
Poor Fair Good Excellent
Do you consume alcohol? ? Yes ? No
If you checked yes, how much do you consume?
Do you currently smoke, or have you ever smoked? ? Yes ? No
If you previously smoked, how long did you smoke, how often, and when did you quit?
If you currently smoke, how often and how much do you smoke?
Do you consider yourself underweight or overweight? (Circle one)
How many meals do you have each day?
3. Fitness Goals and Objectives
Check any of the fitness goals described below which you wish to achieve.
? Improve Strength ? Reduce Stress
? Improve Flexibility ? Increase Strength
? Improve Cardiovascular Fitness ? Stop Smoking/drinking
? Improve Muscle Tone and Shape ? Injury Prevention
? Improve Diet/Eating Habits ? Rehabilitate Injury
? Lose Weight ? Gain Weight/Muscle
? Improve Muscular Endurance
WHOES' YOUR DADDY
A mean motherfucker
Bye that damn book and quite bitching!