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* 1. Name (First and Last):

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* 2. Phone Number:

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* 3. Email Address:

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* 4. Describe Your Current Fitness Level:

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* 5. What Are Your Two Main Goals for Boot Camp? (Select Two)

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* 6. I understand that Climb Boot Camp is a fundraising incentive. Participation in each session requires that I reach a new fundraising level. Each session’s fundraising requirement must be met by the day of that session. I plan to meet the fundraising requirement to participate in the following Climb Boot Camp sessions.

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