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Fitness Vacation Application

Full First/Last Name:	____________________________________________________________
Home Address:	_________________________________________________________________________
City:	_____________________	State:	_______	Zip:	___________
Country:	____________________
Daytime Phone #:	(______)____________________
Evening Phone #:	(______)____________________
Email Address:	_______________________
Alternate Email Address:	_______________________
*Name of spouse or friend(s) traveling with you:**	____________________________________________________________ ____________________________________________________________

*Note: each participant needs to complete a separate application.

Please select the Fitness Vacation that you'd like to attend:


___	Cozumel, Mexico		___	Acapulco, Mexico		___	Myrtle Beach, SC

Please select the day and time for your one-on-one training with Dani Myers, GHF's Exercise Expert, to discuss your workout program. Please number choices 1, 2, and 3.


___	Sunday early morning	___	Sunday mid-morning	___	Sunday late morning
___	Sunday early afternoon	___	Sunday mid-afternoon	___	Sunday late afternoon
___	Monday early morning	___	Monday mid-morning	___	Monday late morning
___	Monday early afternoon	___	Monday mid-afternoon	___	Monday late afternoon
___	Tuesday early morning	___	Tuesday mid-morning	___	Tuesday late morning
___	Tuesday early afternoon	___	Tuesday mid-afternoon	___	Tuesday late afternoon

___	Not interested in taking advantage of this option.

Please indicate if you'd like to share this time with your traveling companion(s) and include their names: ____________________________________________________________ ____________________________________________________________

Please select the day and time for your one-on-one consulting with Dr. Frank Smoot, GHF's Success Coach & Personal Growth Expert, to discuss any barriers you're experiencing towards fitness success. Please number your choices 1, 2, and 3.


___	Wednesday early morning	___	Wednesday mid-morning	___	Wednesday late morning
___	Wednesday early afternoon	___	Wednesday mid-afternoon	___	Wednesday late afternoon
___	Thursday early morning	___	Thursday mid-morning	___	Thursday late morning
___	Thursday early afternoon	___	Thursday mid-afternoon	___	Thursday late afternoon
___	Friday early morning	___	Friday mid-morning	___	Friday late morning
___	Friday early afternoon	___	Friday mid-afternoon	___	Friday late afternoon

___	Not interested in taking advantage of this option.

Please indicate if you'd like to share this time with your traveling companion(s) and include their names: ____________________________________________________________ ____________________________________________________________

Please select the day and meal you'd like to spend with Tom Venuto, GHF's Fat Loss Expert, or Chad Tackett, GHF's President, to discuss a successful diet program. Please number your choices 1, 2, and 3:


___	Monday Breakfast	___	Monday Lunch	___	Monday Dinner
___	Tuesday Breakfast	___	Tuesday Lunch	___	Tuesday Dinner
___	Wednesday Breakfast	___	Wednesday Lunch	___	Wednesday Dinner
___	Thursday Breakfast	___	Thursday Lunch	___	Thursday Dinner
___	Friday Breakfast	___	Friday Lunch	___	Friday Dinner
___	Saturday Breakfast	___	Saturday Lunch

___	Not interested in taking advantage of this option.

Please indicate if you'd rather spend this time with Tom or with Chad: _______________

Please also indicate if you'd like to share this time with your traveling companion(s) and include their names: ____________________________________________________________ ____________________________________________________________

Please answer the following to help us better serve you ...

1. Please briefly explain your body type, including your height, weight, and body fat percentage (if available). Also include your age.

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______________________________________________________________________________________
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2. Do you have any special limitations, diseases, injuries, food allergies, etc. that we should know about?

3. What you would like to accomplish from your exercise and nutrition program (for example, increased muscle size and/or tone, decreased body fat, more energy, etc.)?

4. How many days per week and how many minutes per session are realistic for you to exercise?

5. Do you have a health club or available home equipment (if the latter, please list)?

6. What "fitness level" would you consider yourself to be: Beginner? Intermediate? Advanced? How much weightlifting and cardiovascular exercise experience do you have?

Payment Information:

For seven (7) full days and nights of top-quality accommodations PLUS nationally renowned personal consulting and all the free bonuses, you pay just $750 per person, or $650 each for a group of two. If you have more than one other friend or spouse who may be interested in joining you, e-mail us for a price quote based on the number of your party.


__ I have included a check or money order for the total amount of ____ for the following participants:
____________________________________________________________ ____________________________________________________________

__ I prefer to pay by credit card.

Credit Card #: ______________________________________	Expires: __________
Name as it appears on the card: ____________________________________________
Please charge my credit card ______ for the following additional participants:
____________________________________________________________ ____________________________________________________________ Please make checks payable to GHF and mail payment info to: GHF P.O. Box 2696 Clackamas, OR 97015-2696

Fitness Vacation Agreement & Disclaimer:


The information provided at each of our Fitness Vacations is designed to help you make informed decisions about your health. It is not intended as a substitute for advice or treatment that may have been prescribed by your physician or other health care providers. All of the information provided is made without warrantee, express or implied. Each Fitness Vacation offers GHF's opinion in regards to the subject matter contained therein. GHF, to the maximum extent permitted by law, disclaims any personal liability, injury, loss, or risk incurred as a consequence of the use and application, either directly or indirectly, of any advice, information, or methods presented at the Fitness Vacation. Before attending the Fitness Vacation and adhering to any of the GHF information or recommendations, you should consult with your physician and/or get a physical examination, especially if you are considered to be at risk for potential problems resulting from an exercise program and/or making changes in your diet. Click on the "physical examination" link above for guidelines about health and lifestyle factors that are considered risks to someone entering an exercise program. By attending the Fitness Vacation, you understand and agree that you are solely responsible for the way that the information provided by GHF's experts is perceived and utilized and that you do so at your own risk. In no way will you hold GHF, nor any of its owners, officers, directors, employees, agents, information providers, experts, partners, affiliates, or the resort responsible for any injuries or problems that might occur due to you attending GHF's Fitness Vacation. Notwithstanding the foregoing or following paragraphs, the total liability of GHF and its owners, officers, directors, employees, agents, information providers, experts, partners, affiliates, or resort, if any, for losses or damages shall not exceed the fees paid by you for the particular information or service provided. All other damages, direct or indirect, special, incidental, consequential, or punitive arising from any use of the information or other parts of the Fitness Vacation are hereby excluded even if GHF or its owners, officers, directors, employees, agents, information providers, experts, partners, affiliates, or the resort have been advised of the possibility of such damages. Signing below indicates that you have read the five paragraphs above entirely, understand them completely, and agree to be bound by these terms.

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Date	Full legal name	Signature