1. health and fitness

Get Burly Fitness Clinic-Co Sponsored by The
Town of Reading Parks and Recreation
Prepared by Get Burly LLC Founder & Vice President:
Michael Caron and Shannon Manning
*www.getburly.com* for more information on staff!
[email protected] for any questions/concerns!
Get Burly is a fitness program designed to promote athletes to be the best version of themselves through supporting their peers and through fitness.
Our mission is to instill and inspire youth to develop a passion for fitness through
group circuit training and team building games. Participants will engage in
group circuit training as well as a variety of team building activities and cooperative games. This program will enhance fitness and leadership skills.
1 week Fitness Clinic
July 6-9 RMHS Football Field 62 Oakland Rd. Reading Massachusetts
Days: Monday- Thursday
July 6-9
Duration:
9:00am-1:00 pm
Focus Areas:Introduction of fitness principles
through team building games and group circuit training.
Target Audience: Grades 5-12
Price: $199, $20 off for add family members
Passion: Pursuing your passions with great intensity and discipline.
Realization: Acknowledging that excuses are detrimental to the process of
growth.
Commitment: Making and sustaining the necessary commitment to be the
best version of yourself.
Fitness is a platform for a successful and healthy future.
Payment must be made and release form signed in order to participate in this
camp.
Registration can be can be printed and checks can mailed
directly to:
Get Burly LLC
101 Lakeshore Dr.
Georgetown Ma. 01833
Participants Name:_____________________________________________
Parents Name: ____________________________________________
Parents Telephone: Home___________________________________
Cell:____________________________________________________
Emergency Contact name and Number:______________________________________
I verify that my child has been examined by a licensed physician and is physically able to participate in the Get
Burly Fitness Clinic. I hereby agree and promise to indemnify and hold harmless the Town of Reading, or any of
their employees, Get Burly, LLC, also ,doing business as “The Get Burly Company”, any Get Burly employees responsible for any loss, damage, or personal injuries received as a result of participation in this clinic and or transportation to and from the clinic, and/or any agents, contractors, or assignees of the Get Burly. I hereby authorize the
directors or assigned personnel, as applicable, of the Get Burly Fitness Clinic to act according to their best judgment
in any emergency requiring medical attention. I hereby authorize my consent for my child to be treated by an athletic
trainer or licensed physician, if necessary, and to assume all costs related to such disclosure of medical information
to my insurance for the purpose of the claim. Nothing in this consent shall waive any rights I as parent or guardian
of a minor child are guaranteed under federal Health Insurance Portability and Accountability Act (HIPPAA) law, its
state law companions, or any other applicable law, federal, state, or municipal.
Printed Name:_________________________________________________
Signature:____________________________________________________
Date: ____________________________
Insurance Co/Policy #:
___________________________________________________________________________________________
____________________________________________________________________________
Please list any medical history, injuries, concerns, allergies, etc.
_____________________________________________________________________________________________
_______________________________________________________________________
____________________________________________________________________________
______________________________________________________________________________________
Check us out at WWW.GETBURLY.COM
Contact: Michael Caron @ [email protected] or Shannon Manning @ [email protected]