Risk Free Reservation/Registration Page

Free Class Registration

YES! I want to reserve my spot for a FREE workout at Action Potential's “Four Weeks To Freedom” Boot Camp for Women so I can try-before-I-buy. I understand there is a $10 reservation fee to hold my spot in the free class (space is limited) and that my $10 will either be applied towards my full enrollment fee should I decide to join, or refunded to me after the free class if I decide not to join.

I also understand that if I do not show up for the free class, I forfeit the $10 reservation fee. I recognise you do this to ensure accountability – which is a critical element to my success with Boot Camp. Finally, I understand you will immediately email me confirmation and details I need to know prior to the FREE class, or I can call your office directly at (03) 9723 9863.

On that basis I am submitting my request to reserve a spot in the next FREE Boot Camp Class by selecting the appropriate camp below:

___________________________________________

Yes! Please Reserve My Spot For The Upcoming FREE Boot Camp Class. I understand that you will contact me shortly after submitting this form to complete my registration over the phone.

Please select the Boot Camp Location, Session Times That You'd Like To Do and the Start Date. Check the calendar page to see upcoming dates by clicking here.

The Boot Camps We Have On Offer Are As Follows:

Croydon Boot Camp: Kalinda Primary School, Kalinda Road, Ringwood
Mornings: 6am-7am Mon and Wed & 8am-9am Sat
Evenings: 6:30-7:30pm Mon, Tue, Fri

Mooroolbark Boot Camp: Mooroolbark East Primary School, Taylors Rd, Mooroolbark
Camp 1: 6-7am, Tue, Thu, Fri
Camp 2: 6:30pm-7:30pm Mon, Tues, Thurs

Headquarters (Action Potential Studio) Action Potential, Shop 3/12-14 Thomas Brew Lane, Croydon, VIC
Mornings (Women's Only Classes): Mon, Tue, Thu 9:30-10:30am
Evenings (Mixed Gender Classes): Mon, Tue, Thu 7.30-8.30pm

First Name*

Last Name*

E-Mail*

Mobile Phone*

Address*

City*

StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareD.C.FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew MexicoNew JerseyNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon(AU) Australian Capital Territory(AU) New South Wales(AU) Victoria(AU) Queensland(AU) Northern Territory(AU) Western Australia(AU) South Australia(AU) Tasmania(AF) Gauteng(AF) Western Cape(AF) Eastern Cape(AF) Kwa-Zulu Natal(AF) North West(AF) Northern Cape(AF) Mpumulanga(AF) Free StateMy State is not listed

Post Code*

Boot Camp LocationCroydon - Kalinda PrimaryMooroolbark - Mooroolbark East PrimaryMixHeadquarters - Action Potential Studio

Session TimeKalinda - MorningKalinda - EveningMix (see note)Mooroolbark Camp 1Mooroolbark Camp 2Headquarters - MorningHeadquarters - Evening

Start Date09/01/12 23/01/12 06/02/1220/02/1205/03/1219/03/1202/04/1216/04/1230/04/1214/05/1228/05/1211/06/1225/06/1209/07/1223/07/1206/08/1220/08/1203/09/1217/09/1201/10/1215/10/1229/10/1212/11/1226/11/1210/12/12

Any Notes or Questions Regarding Sessions

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Boot Camp Registration

YES! I know this is exactly what I need and I want to go ahead and register right now for the Action Potential “Four Weeks To Freedom” Boot Camp for Women by completing my registration form and submitting payment for the upcoming Boot Camp.

I understand this entitles me to a spot in Boot Camp and that my enrollment fee is completely RISK-FREE because of your 100% Money Back Guarantee of satisfaction. I understand you will immediately email me confirmation and details I need to know prior to Boot Camp, or I can call your office directly at
(03) 9723 9863.

On that basis I am submitting my request to register for Boot Camp by select the appropriate camp below:
___________________________________________

Yes! Please Reserve My Spot For The Upcoming Boot Camp. I want to succeed and achieve my fitness goals! I am signing up for 4 Weeks of 3 x 1 hour sessions. I understand that you will contact me shortly after submitting this form to complete my registration over the phone.

Also note that cheaper options are available by committing for a longer period.

1 x 4 Week Boot Camp = $197 ($16.40 per session)
3 x 4 Week Boot Camp = $179 per boot camp ($14.90 per session)
6 x 4 Week Boot Camp = $159 per boot camp ($13.25 per session)
12 x 4 Week Boot Camp = $139 per boot camp ($11.60 per session)

Please select the Boot Camp Location, Session Times That You'd Like To Do and the Start Date. Check the calendar page to see upcoming dates by clicking here. Also indicate in the "Notes" section what commitment you'd like to make.

The Boot Camps We Have On Offer Are As Follows:

Croydon Boot Camp: Kalinda Primary School, Kalinda Road, Ringwood
Mornings: 6am-7am Mon and Wed & 8am-9am Sat
Evenings: 6:30-7:30pm Mon, Tue, Fri

Mooroolbark Boot Camp: Mooroolbark East Primary School, Taylors Rd, Mooroolbark
Camp 1: 6-7am, Tue, Thu, Fri
Camp 2: 6:30pm-7:30pm Mon, Tues, Thurs

Headquarters (Action Potential Studio) Action Potential, Shop 3/12-14 Thomas Brew Lane, Croydon, VIC
Mornings (Women's Only Classes): Mon, Tue, Thu 9:30-10:30am
Evenings (Mixed Gender Classes - Bring Your Hubby!!): Mon, Tue, Thu 7.30-8.30pm

First Name*

Last Name*

E-Mail*

Mobile Phone*

Address*

City*

StateAlabamaAlaskaArizonaArkansasCaliforniaColoradoConnecticutDelawareD.C.FloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew MexicoNew JerseyNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingAlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNova ScotiaNorthwest TerritoriesNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon(AU) Australian Capital Territory(AU) New South Wales(AU) Victoria(AU) Queensland(AU) Northern Territory(AU) Western Australia(AU) South Australia(AU) Tasmania(AF) Gauteng(AF) Western Cape(AF) Eastern Cape(AF) Kwa-Zulu Natal(AF) North West(AF) Northern Cape(AF) Mpumulanga(AF) Free StateMy State is not listed

Post Code*

Boot Camp LocationCroydon - Kalinda PrimaryMooroolbark - Mooroolbark East PrimaryMixHeadquarters - Action Potential Studio

Session TimeKalinda - MorningKalinda - EveningMix (see note)Mooroolbark Camp 1Mooroolbark Camp 2Headquarters - MorningHeadquarters - Evening

Start Date 09/01/12 23/01/1206/02/1220/02/1205/03/1219/03/1202/04/1216/04/1230/04/1214/05/1228/05/1211/06/1225/06/1209/07/1223/07/1206/08/1220/08/1203/09/1217/09/1201/10/1215/10/1229/10/1212/11/1226/11/1210/12/12

Any Notes or Questions Regarding Sessions

Best Time To Contact