Boot Camp Registration
"It's NEVER too late to start building your New Image"


  • Medical forms will be emailed to you shortly after you register.
     
  • Registrants should then email or fax a completed copy of the forms back to New Image several days before class (to guarantee a spot),
     
  • Registrants must also bring a signed version to the first class!
     
  • You may also register by phone or email.
     
  • We will email you to confirm your registration.
     
  • To Register for Tues/Thurs, Topaz Camps Click Here

Personal information
First Name: Last Name:
Address:
City: Postal Code:
Province: Country:
Phone: Email:
How did you hear about us?:
Medical information
Name of Doctor: Doctor Phone:
Care Card #:
Medical Conditions:
(Please list any Medical Conditions that may affect you participation in our Boot Camps, or should be know in case of an emergency. Example medical conditions such as heart disease, injuries, or anything that might concern you.)
Emergency Contacts
Contact #1 Name: Phone #:
Relationship:
Contact #2 Name: Phone #:
Relationship:
Boot Camp Selection
Start Date:
(Please see our Calendar/Schedule for more details)
Class Time:
KIV Discount:
DND Discount:
Length of Boot Camp:
One 2 week Boot Camp $99 CDN
One 4 week Boot Camp $175 CDN
Two Boot Camps $300 CDN
Four Boot Camps $550 CDN
Eight Boot Camps $1000 CDN
*Special* 3 months $375 CDN
10 Session Punch Card $166.75 CDN
(Price's don't include the 5% GST)
Do you give us permission to use photographs of your participation in our Bootcamp on our webpage?
Yes
No
Do you wish to pay online for your Boot Camp following the submission of your registration?
You may pay the full amount due for your Boot Camp(s) or pay the minimum 25% deposit to secure your spot in the camp and pay the remainder later.
Yes, Pay the Full Amount Due
Yes, Pay only the 25% deposit
Yes, Pay the KIV Bootcamp Price
Yes, Pay the DND Bootcamp Price
Yes, Pay for Punch Card
No
Enter the text in the image to proceed:
If you have any questions about the registration, please feel free to contact us.

Remember, Show up 15 minutes early to your first class, 5 minutes early to all other classes.
New Image Boot Camps are a service of New Image Bootcamps Inc. (250-884-3980). Victoria, British Columbia, Canada.