2010-03-09T18:05:17-06:00 2128 203101 2010-03-09T18:05:17-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Neringa Sabataityte</name><address>834 Washington st Rear Apt.</address><city_state_zip>Cape May</city_state_zip><phone>6099729363</phone><email>neringa.sab@gmail.com</email><emergency_contact>sonata</emergency_contact><emergency_phone_>6099721516</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>i want to sign up for this month, even though i am late. I also have a 25$ off card. </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Neringa Sabataityte</2></root> 2010-03-02T09:55:52-06:00 2128 198921 2010-03-02T09:55:52-06:00 <root><i_am_interested_in>Nutrition</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marie Freddo</name><address>209 Second Ave</address><city_state_zip>West Cape May NJ 08204</city_state_zip><phone>267-471-3285</phone><email>mfreddo@comcast.net</email><emergency_contact>Bill Freddo</emergency_contact><emergency_phone_>267-471-3289</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Marie A. Freddo</2></root> 2010-03-02T06:09:02-06:00 2128 198781 2010-03-02T06:09:02-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Sherry</name><address>1 Cedar Grove Drive</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-390-4787</phone><email/><emergency_contact>Craig Jurasinski</emergency_contact><emergency_phone_>609-390-4787</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>omeprazole, GERD</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Sherry Jurasinski</2></root> 2010-02-27T12:11:29-06:00 2128 197051 2010-02-27T12:11:29-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kimberly Klug</name><address>315 Court House- S. Dennis Rd.</address><city_state_zip>Cape May Court House, NJ, 08210</city_state_zip><phone>609-463-9325</phone><email>klugkim@comcast.net</email><emergency_contact>Deborah J. Klug</emergency_contact><emergency_phone_>609-465-8293</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>xanac, ambien- anxiety disorder, insomnia, phentermine- obesity</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no, </do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kimberly A. Klug</2></root> 2010-02-25T20:22:24-06:00 2128 195801 2010-02-25T20:22:24-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susan DeStefano</name><address>64 N. Ravenwood Drive</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-624-9118</phone><email>Suzierio2001@yahoo.com</email><emergency_contact>Fran DeStefano</emergency_contact><emergency_phone_>609-374-4240</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>high, a few times</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>arthitis in knee</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>heart pace maker</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susan DeStefano</2></root> 2010-02-25T14:46:25-06:00 2128 195501 2010-02-25T14:46:25-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>sandra cowan</name><address>101 county road</address><city_state_zip>cape may court house nj 08210</city_state_zip><phone>6096750502</phone><email>sandygirl02@yahoo.com, cowanss1@comcast.net</email><emergency_contact>steve</emergency_contact><emergency_phone_>6097802050</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>came in feb, re-sign up for march.. </please_explain><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>n</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>sandra m. cowan</2></root> 2010-02-21T17:28:01-06:00 2128 192511 2010-02-21T17:28:01-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Maryanne D. Payne</name><address>9 Rose Lane</address><city_state_zip>Villas</city_state_zip><phone>6098867181</phone><email>hwpayne2@verizon.net</email><emergency_contact>Herbert Payne</emergency_contact><emergency_phone_>6098867181</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>lexapro &amp; alegra d</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Maryanne D. Payne</2></root> 2010-02-21T08:41:04-06:00 2128 192221 2010-02-21T08:41:04-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marian Courtney</name><address>104 Second Ave</address><city_state_zip>West Cape May, NJ 08204</city_state_zip><phone>609-408-3242</phone><email>marianc71@gmail.com</email><emergency_contact>Philip Courtney</emergency_contact><emergency_phone_>609-827-1959</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Currently in February Boot Camp MWF 5:30-6:30</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Marian B. Courtney</2></root> 2010-02-19T04:51:30-06:00 2128 190921 2010-02-19T04:51:30-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lori Schulte</name><address>204 Del Val Rd.</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609 425-8006</phone><email>lorischulte@mac.com</email><emergency_contact>Paul Schulte</emergency_contact><emergency_phone_>609 425-8007</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Hey Nick, For the March session, I&apos;m signing up for Tues/Thurs but I&apos;m wondering if I can do Tuesday in Rio and Wednesday in Seaville at 7:30. Will this be ok? Lori</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lori Schulte</2></root> 2010-02-18T13:33:33-06:00 2128 190671 2010-02-18T13:33:33-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Theresa Netz</name><address>40 Narrows Road</address><city_state_zip>Woodbine, NJ 08270</city_state_zip><phone>609-463-2298</phone><email>tnetz@caperegional.com</email><emergency_contact>Bruce Myers</emergency_contact><emergency_phone_>609-820-5945</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I have a PACBOOTCAMP.COM $25.00 off coupon given to me by Nancy Lang. Tara Royer also has a coupon.</please_explain><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Theresa Netz</2></root> 2010-02-18T11:10:44-06:00 2128 190571 2010-02-18T11:10:44-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Maegan Farrington</name><address>P.O Box 141</address><city_state_zip>Woodbine, NJ, 08270</city_state_zip><phone>(609)827-1970</phone><email>mego858@hotmail.com</email><emergency_contact>Donna Farrington</emergency_contact><emergency_phone_>(609)408-8650</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>It was only during my pregnancy. </has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>birth control, aleve for headaches</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>none</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>none</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Maegan Farrington</2></root> 2010-02-18T05:58:39-06:00 2128 190401 2010-02-18T05:58:39-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tara Royer</name><address>1001 Augusta court</address><city_state_zip>Cape May Court House</city_state_zip><phone>609-846-5888</phone><email>myleahm@msn.com</email><emergency_contact>karasue royer</emergency_contact><emergency_phone_>609-463-0406</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes. take BP med. it is under control</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>verapymil high bp</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>have neck issue herniated disc c-spine</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tara J Royer</2></root> 2010-02-17T15:32:43-06:00 2128 190061 2010-02-17T15:32:43-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>annefrances benichou</name><address>301 east 24th avenue</address><city_state_zip>north wildwood, nj, 08260</city_state_zip><phone>609-523-9192</phone><email/><emergency_contact>simon benichou</emergency_contact><emergency_phone_>609-972-9128</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>a benichou</2></root> 2010-02-16T23:49:47-06:00 2128 189701 2010-02-16T23:49:47-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Ellen Furey-Conger (LYN)</name><address>91 corson tavrn rd</address><city_state_zip>seaville nj 08230</city_state_zip><phone>4866303</phone><email>furey-conger@comcast.net</email><emergency_contact>deb giuliano</emergency_contact><emergency_phone_>4652765</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I did the boot camo last may/june/july/sept</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>on bp meds</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>htn</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>ellen furey conger</2></root> 2010-02-12T13:43:10-06:00 2128 187141 2010-02-12T13:43:10-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debbie Greene</name><address>25 Mimosa Dr</address><city_state_zip>Rio Grande NJ 08242</city_state_zip><phone>609-408-6800</phone><email/><emergency_contact>609-408-6801</emergency_contact><emergency_phone_>609-886-1119</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deborah Greene</2></root> 2010-02-11T19:33:04-06:00 2128 186831 2010-02-11T19:33:04-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>danielle ohara</name><address>75 West 26th Street</address><city_state_zip>NJ</city_state_zip><phone>609 9673891</phone><email>dnapo@comcast.net</email><emergency_contact>casey ohara</emergency_contact><emergency_phone_>2158054705</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>danielle ohara</2></root> 2010-02-09T11:49:55-06:00 2128 185611 2010-02-09T11:49:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Carol Tutelian</name><address>19 Elizabeth lane</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-390-3484</phone><email>ctutelian@watersedgellc.com</email><emergency_contact>Howard Tutelian</emergency_contact><emergency_phone_>780-7743</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>carol tutelian</2></root> 2010-02-01T19:44:03-06:00 2128 181161 2010-02-01T19:44:03-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melissa Wells</name><address>408 Springdale Court</address><city_state_zip>CMCH NJ 08210</city_state_zip><phone>609 463 5356</phone><email>druwells@comcast.net</email><emergency_contact>Andrew Wells</emergency_contact><emergency_phone_>609 231 1935</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Wellbutrin- depression</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melissa Wells</2></root> 2010-01-29T10:38:30-06:00 2128 178991 2010-01-29T10:38:30-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>sandra</name><address>cowan</address><city_state_zip>cape may court house nj. 08210</city_state_zip><phone>6096750502</phone><email>sandygirl02@yahoo.com</email><emergency_contact>dawn williams</emergency_contact><emergency_phone_>6094257007</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>sandra m. cowan</2></root> 2010-01-28T09:58:03-06:00 2128 178381 2010-01-28T09:58:03-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kelly Hewitt</name><address>3124 Bayshore Road</address><city_state_zip>Cape May NJ 08204</city_state_zip><phone>6098279211</phone><email>cnkhewitt@comcast.net</email><emergency_contact>Charles Hewitt</emergency_contact><emergency_phone_>6098278519</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>synthroid</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kelly Hewitt</2></root> 2010-01-28T00:18:03-06:00 2128 178211 2010-01-28T00:18:03-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Angel Anderson</name><address>725 North Shore Rd</address><city_state_zip>Beesleys Point, NJ 08223</city_state_zip><phone>609-486-6521</phone><email>jd4me3@aol.com</email><emergency_contact>Jay Potter</emergency_contact><emergency_phone_>6093776853</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Celexa, anxioty</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Angel Rae Anderson</2></root> 2010-01-26T07:49:18-06:00 2128 177111 2010-01-26T07:49:18-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Cathy Leahy</name><address>40 W. Shellbay Avenue</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-7009</phone><email>cathyleahy@yahoo.com</email><emergency_contact>John Leahy</emergency_contact><emergency_phone_>609-602-4033</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Nick, Can believe I am actually enjoying this, never thought I would say that.....lol Thanks Cathy </please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Cathy Leahy</2></root> 2010-01-25T11:08:05-06:00 2128 176631 2010-01-25T11:08:05-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Patricia Burk</name><address>215 E. 24th Street </address><city_state_zip>No. Wildwood, NJ 08260</city_state_zip><phone>609-670-9655</phone><email>ptrcburk@yahoo.com</email><emergency_contact>Peggy Gretz</emergency_contact><emergency_phone_>609-6709655</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Patricia Burk</2></root> 2010-01-24T20:20:36-06:00 2128 176271 2010-01-24T20:20:36-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Sandra Donley</name><address>17 Swainton Goshen Road</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-2554</phone><email>samjon54@comcast.net</email><emergency_contact>John Donley Jr</emergency_contact><emergency_phone_>609-465-2554</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>Afib/Aflutter</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>Previously was low due to medication</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Yes-Rythmol and Cadizem for Afib/flutter</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Sandra L Donley</2></root> 2010-01-22T22:45:04-06:00 2128 175241 2010-01-22T22:45:04-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kelly Heckler</name><address>3 Turtle Thorofare Crt</address><city_state_zip>CMCH NJ 08210</city_state_zip><phone>609-602-8403</phone><email>Kellyheckler@gmail.com</email><emergency_contact>MaryAnn Heckler</emergency_contact><emergency_phone_>609-425-3416</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kelly Heckler</2></root> 2010-01-20T06:09:38-06:00 2128 172251 2010-01-20T06:09:38-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joni Brennan</name><address>321 Asbury Avenue</address><city_state_zip>Ocean City, NJ 08226</city_state_zip><phone>609-972-7663</phone><email>seasideponee@aol.com</email><emergency_contact>Maureen Caprio</emergency_contact><emergency_phone_>7320796-5537</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Lisinopril, Levothyroxine, </are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Joan Brennan</2></root> 2010-01-19T19:07:06-06:00 2128 172031 2010-01-19T19:07:06-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>jill Lapworth</name><address>730 Dias Creek Road</address><city_state_zip>cmch n.j. 08210</city_state_zip><phone>609 425-7075</phone><email>jillheather@comcast.net</email><emergency_contact>Dottie Lapworth</emergency_contact><emergency_phone_>609 675-0053</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>paxil 10 mg depression</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jill Lapworth</2></root> 2010-01-18T20:05:44-06:00 2128 171391 2010-01-18T20:05:44-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joni Brennan</name><address>321 Asbury Avenue</address><city_state_zip>Ocean City, nj 08226</city_state_zip><phone>609-972-7663</phone><email>SEASIDEPONEE@AOL.COM</email><emergency_contact>Maureen Caprio</emergency_contact><emergency_phone_>732-796-5537</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I missed the fist session in Seaville. Can I still sign up?</please_explain><do_you_have_any_known_cardiovascular_problems>,MILD HYPERTENSION</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>MILDLY</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Lisinopril, levothyroxine</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>Hypothyroidism</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Joan Brennan</2></root> 2010-01-18T14:07:39-06:00 2128 171171 2010-01-18T14:07:39-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joanne Budd</name><address>109 Fulling Mill rd</address><city_state_zip>Villas, NJ, 08251</city_state_zip><phone>609-576-3754</phone><email>jmbudd1012@yahoo.com</email><emergency_contact>Ben Budd</emergency_contact><emergency_phone_>609-374-4751</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes after i had a baby</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>acl surgeries</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Joanne Budd</2></root> 2010-01-18T10:26:27-06:00 2128 171021 2010-01-18T10:26:27-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melanie Smith</name><address>147 Cedar Lane East</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-602-5210</phone><email>melcatsmith@comcast.net</email><emergency_contact>Craig Smith</emergency_contact><emergency_phone_>6096021890</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I would like to try m/w mornings and friday evenings in Seaville - is it possible to swap between times?</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes - stress led to digestive absorption issues and resulted in high blood pressure. Not an issue now.</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>multivitamin, caltrate, vitamin c</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melanie Smith</2></root> 2010-01-17T13:58:36-06:00 2128 170461 2010-01-17T13:58:36-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>tara moore</name><address>125 e taylor ave</address><city_state_zip>wildwood, nj ,08260</city_state_zip><phone>609-224-5743</phone><email/><emergency_contact>marie focht</emergency_contact><emergency_phone_>609-465-4607</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>tara moore</2></root> 2010-01-17T13:56:55-06:00 2128 170451 2010-01-17T13:56:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>jamie menz</name><address>15 eldredge ave</address><city_state_zip>del haven, nj, 08251</city_state_zip><phone>609-556-4009</phone><email>jfmenz31@yahoo.com</email><emergency_contact>david harris</emergency_contact><emergency_phone_>609-556-4093</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>jamie menz</2></root> 2010-01-17T10:15:41-06:00 2128 170371 2010-01-17T10:15:41-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Denise Pote</name><address>119 Carlisle Place Rd</address><city_state_zip>Dorchester NJ 08316</city_state_zip><phone>856-506-2811</phone><email>dp36087@aol.com</email><emergency_contact>Gary Pote</emergency_contact><emergency_phone_>856-506-1011</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Round 2</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>premarin hrt; wellchol cholesterol zoloft depression/anxiety</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>arthritis in knees mild</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Denise Pote</2></root> 2010-01-11T10:07:55-06:00 2128 165121 2010-01-11T10:07:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kim Servis</name><address>1076 Pamela Drive</address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>609-575-2867</phone><email>kbuck123@aol.com</email><emergency_contact>John Fulton</emergency_contact><emergency_phone_>609-408-7227</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kim Servis</2></root> 2010-01-11T10:05:22-06:00 2128 165091 2010-01-11T10:05:22-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Karen Gasior</name><address>440 E. 24th Avenue</address><city_state_zip>N. Wildwood, NJ 08260</city_state_zip><phone>609-501-1943</phone><email>shoptiludrop43@comcast.net</email><emergency_contact>Marie Sacchetti</emergency_contact><emergency_phone_>856-691-0046 (c) 609-364-0694</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Yes-bad knees/neck</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Karen Gasior</2></root> 2010-01-09T09:09:10-06:00 2128 163871 2010-01-09T09:09:10-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Patty Watson</name><address>134 Sunset Drive</address><city_state_zip>Erma</city_state_zip><phone>609-846-3495</phone><email/><emergency_contact>Jim Watson</emergency_contact><emergency_phone_>609-886-5103</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>Pacemaker</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Knee surgery, years ago no prob now</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Patty Watson</2></root> 2010-01-06T15:02:45-06:00 2128 162131 2010-01-06T15:02:45-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Cathy Leahy</name><address>40 W. Shellbay Avenue</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-7009</phone><email>cathyleahy@yahoo.com</email><emergency_contact>John Leahy</emergency_contact><emergency_phone_>609-602-4033</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hope this works Nick!!!!</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Cathy Leahy</2></root> 2010-01-06T10:32:55-06:00 2128 161961 2010-01-06T10:32:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Michelle O&apos;Hara</name><address>30 Wildwood Avenue</address><city_state_zip>Villas NJ 08251</city_state_zip><phone>6094258337</phone><email>1bookkeeper@comcast.net</email><emergency_contact>William McPherson</emergency_contact><emergency_phone_>609-780-7653</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Michelle O&apos;Hara</2></root> 2010-01-06T06:40:55-06:00 2128 161771 2010-01-06T06:40:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Sandra Donley</name><address>17 Swainton Goshen Road</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-2554</phone><email>samjon54@comcast.net</email><emergency_contact>John Donley</emergency_contact><emergency_phone_>609-465-2554 or 609-425-3763</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I was a memeber of boot camp this summer in Seaville. Had some post surgery issues and had to stop coming. I have medical clearence return to boot camp. </please_explain><do_you_have_any_known_cardiovascular_problems>Yes -A-fib and A flutter</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>Medication-causes low blood pressure at times</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Yes Rythmol-heart rate, Cardizem-heart rate</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Sandra L Donley</2></root> 2010-01-05T09:41:59-06:00 2128 161191 2010-01-05T09:41:59-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melida</name><address>225 School Ln</address><city_state_zip>rio grande</city_state_zip><phone>886-1976</phone><email>tneir@aol.com</email><emergency_contact>Tim MacNeir</emergency_contact><emergency_phone_>609-827-8815</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melinda Dunleavy</2></root> 2010-01-05T09:39:12-06:00 2128 161171 2010-01-05T09:39:12-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Roberta</name><address>225 School Ln</address><city_state_zip>rio grande</city_state_zip><phone>609-886-1976</phone><email>tneir@aol.com</email><emergency_contact>Tim MacNeir</emergency_contact><emergency_phone_>609-827-8815</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>armour thyroid</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Roberta MacNeir</2></root> 2010-01-04T13:11:26-06:00 2128 160001 2010-01-04T13:11:26-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Renee Angelastro</name><address>504 S Railroad Avenue</address><city_state_zip>Rio Grande, NJ 08242</city_state_zip><phone>609-602-8812</phone><email>reneeangelastro@comcast.net</email><emergency_contact>Marta or Rocco Angelastro ( mom or dad)</emergency_contact><emergency_phone_>609-425-2666</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hey Nick, I just spoke with you over the phone about joinging boot camp on Tues/Thurs at 6pm. I will be there tomorrow 1/5/10 and will submit payment for the class. Thanks again. Renee</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>kariva, birth control</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Renee Angelastro</2></root> 2010-01-03T18:21:12-06:00 2128 159261 2010-01-03T18:21:12-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mindy Hoag</name><address>32 Mockingbird Lane</address><city_state_zip>Petersburg, NJ 08270</city_state_zip><phone>6096284379</phone><email>mbhoag3@comcast.net</email><emergency_contact>Rich Hoag</emergency_contact><emergency_phone_>226-4899</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Mindy Hoag</2></root> 2010-01-02T10:06:44-06:00 2128 158521 2010-01-02T10:06:44-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lu Ann Flacco</name><address>12 Lomurno Lane</address><city_state_zip>CMCH, NJ 08210-2537</city_state_zip><phone>(609) 517-4659</phone><email>lafsices@comcast.net</email><emergency_contact>Tony Sbarra</emergency_contact><emergency_phone_>(609) 517-4262</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>heart murmur</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lu Ann Flacco</2></root> 2010-01-01T12:54:13-06:00 2128 158131 2010-01-01T12:54:13-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Deanne Sihr</name><address>482 Corson Tavern Rd</address><city_state_zip>Ocean View, NJ 08230</city_state_zip><phone>609-425-6679</phone><email>lifebythebeach@comcast.net</email><emergency_contact>Mike Fry</emergency_contact><emergency_phone_>609-425-6679</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>Yes</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Lisinopril 40.mg</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Lower Back problems with L5 and L6 disk</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deanne k Sihr</2></root> 2010-01-01T10:59:44-06:00 2128 158061 2010-01-01T10:59:44-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 5:00P Co-Ed</for_boot_camp_please_select_the_time_you_are_interested_in><name>vicki dougherty</name><address>10206 3rd Ave</address><city_state_zip>stone harbor nj</city_state_zip><phone>609 6758884</phone><email>vdoc22@hotmail.com</email><emergency_contact>tom tice</emergency_contact><emergency_phone_>6097806105</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NJ</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>vicki dougherty</2></root> 2010-01-01T10:58:03-06:00 2128 158051 2010-01-01T10:58:03-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 5:00P Co-Ed</for_boot_camp_please_select_the_time_you_are_interested_in><name>tom tice</name><address>10206 3rd Ave</address><city_state_zip>NJ</city_state_zip><phone>609 7806105</phone><email>lyletice@gmail.com</email><emergency_contact>vicki dougherty</emergency_contact><emergency_phone_>6096758884</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NJ</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>tom tice</2></root> 2009-12-29T17:05:14-06:00 2128 157381 2009-12-29T17:05:14-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 5:00P Co-Ed</for_boot_camp_please_select_the_time_you_are_interested_in><name>Patty Ackley</name><address>415 W Hildreth Ave Unit D</address><city_state_zip>Wildwood, NJ 08260</city_state_zip><phone>609-774-9176</phone><email>ackpat1@aol.com</email><emergency_contact>.</emergency_contact><emergency_phone_>.</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Yes,Synthroid,Allegra D-Low throyid,Allergies</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Yes,right knee,chrondomalcia,arthritis</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Patty Ackley</2></root> 2009-12-27T12:56:24-06:00 2128 156531 2009-12-27T12:56:24-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>maren gandy</name><address>959 myrtle ave</address><city_state_zip>erma, nj 08204</city_state_zip><phone>6092046514</phone><email>luvmysunflowers@yahoo.com</email><emergency_contact>ike gandy</emergency_contact><emergency_phone_>6098463096</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>n</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>maren r gandy</2></root> 2009-12-24T09:12:11-06:00 2128 155711 2009-12-24T09:12:11-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susan Wilson</name><address>9 Crestview Dr.</address><city_state_zip>Seaville</city_state_zip><phone>3900449</phone><email>animalove2@verizon.net</email><emergency_contact>Ron Wilson</emergency_contact><emergency_phone_>3900449</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susan Wilson</2></root> 2009-12-24T02:58:18-06:00 2128 155581 2009-12-24T02:58:18-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Nancy Martinez</name><address>1004 Franklin St</address><city_state_zip>Woodbine, NJ 08270</city_state_zip><phone>609-231-4769</phone><email>nursenancym@comcast.net</email><emergency_contact>Leticia Donovan-daugther</emergency_contact><emergency_phone_>609-6022157</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>N/A</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>YES</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Prevacid- acid reflux; Glucotro &amp; Glucophage- diabetes</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Nancy Martinez</2></root> 2009-12-24T02:53:22-06:00 2128 155571 2009-12-24T02:53:22-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Nancy Martinez</name><address>1004 Franklin St</address><city_state_zip>Woodbine</city_state_zip><phone>609-231-4769</phone><email>nursenancym@comcast.net</email><emergency_contact>Leticia Donovan-daugther</emergency_contact><emergency_phone_>609-602-2157</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>yes, diagnose 1996</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>prevacid-heartburn; glucophage &amp; glucotrol-diabetis</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Nancy Martinez</2></root> 2009-12-21T19:40:19-06:00 2128 154921 2009-12-21T19:40:19-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danica Stetler</name><address>P.O. Box 166</address><city_state_zip>Leesburg, nj 08327</city_state_zip><phone>8567859878</phone><email>boatworldmarina@yahoo.com</email><emergency_contact>jeff stetler</emergency_contact><emergency_phone_>8567859878</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>danica stetler</2></root> 2009-12-21T19:37:17-06:00 2128 154911 2009-12-21T19:37:17-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danica Stetler</name><address>P.O. Box 166</address><city_state_zip>Leesburg</city_state_zip><phone>8567859878</phone><email>boatworldmarina@yahoo.com</email><emergency_contact>jeff stetler</emergency_contact><emergency_phone_>609-780-0703</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>danica stetler</2></root> 2009-12-21T19:01:27-06:00 2128 154891 2009-12-21T19:01:27-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Denise Pote</name><address>119 Carlisle Place Rd</address><city_state_zip>Dorchester, NJ 08210</city_state_zip><phone>856-506-2811</phone><email>dp36087@aol.com</email><emergency_contact>Gary Pote</emergency_contact><emergency_phone_>856-506-1011</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>borderline</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>premarin-HRT zoloft anxiety, wellcol hypercholesteremia</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no injuries, some arthritis</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Denise Pote</2></root> 2009-12-18T10:48:24-06:00 2128 153731 2009-12-18T10:48:24-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Allison Bove</name><address>17 Solar Way</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-827-1413</phone><email>alliecat021174@yahoo.com</email><emergency_contact>Jeannette Scheidell</emergency_contact><emergency_phone_>609-465-1681</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>OK i am back ....</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>yes , birth control</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>allison bove</2></root> 2009-12-18T10:01:59-06:00 2128 153681 2009-12-18T10:01:59-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Maureen Jackson</name><address>17 West Maple Shade Lane</address><city_state_zip>Marmora, NJ 08223</city_state_zip><phone>6093903816</phone><email>biddymo73@aol.com</email><emergency_contact>joe jackson</emergency_contact><emergency_phone_>609-602-8730</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Maureen Jackson</2></root> 2009-12-16T09:25:22-06:00 2128 153141 2009-12-16T09:25:22-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Shirley Cruz</name><address>102 N. Railroad Ave. </address><city_state_zip>Rio Grande, NJ 08242</city_state_zip><phone>609-536-0712</phone><email>tabu31@yahoo.com</email><emergency_contact>Lady Cruz</emergency_contact><emergency_phone_>609-889-1131</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Shirley A. Cruz </2></root> 2009-12-16T07:28:40-06:00 2128 153081 2009-12-16T07:28:40-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susan Giordano</name><address>7 Cole Ave</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-602-2684</phone><email>info@seaislesuehomes.com</email><emergency_contact>Andy Giordano</emergency_contact><emergency_phone_>609-602-2685</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>MargieLoveless recommended</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susan Giordano</2></root> 2009-12-14T16:01:32-06:00 2128 152161 2009-12-14T16:01:32-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Leia Rapattoni</name><address>6200 Pacific Avenue</address><city_state_zip>Wildwood crest, nj 08260</city_state_zip><phone>609-846-4869</phone><email>leiarapattoni@yahoo.com</email><emergency_contact>Julie Fala</emergency_contact><emergency_phone_>609-886-2821</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>leia rapattoni</2></root> 2009-12-14T07:25:16-06:00 2128 151881 2009-12-14T07:25:16-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>kelly garvey</name><address>165 Washington ave</address><city_state_zip>woodbine, nj 08270</city_state_zip><phone>6094082780</phone><email>garveyjk@comcast.net</email><emergency_contact>861 5573</emergency_contact><emergency_phone_>4327255</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>kelly garvey</2></root> 2009-12-13T21:14:04-06:00 2128 151801 2009-12-13T21:14:04-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>sarah (betsy) sole</name><address>825 cape avenue</address><city_state_zip>cold spring nj 08204</city_state_zip><phone>609-602-3534</phone><email/><emergency_contact>robin gilbert</emergency_contact><emergency_phone_>609-827-3309</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>current boot camper</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>sarah sole</2></root> 2009-12-13T21:10:38-06:00 2128 151791 2009-12-13T21:10:38-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>robin gilbert</name><address>1621 beach drive #108</address><city_state_zip>cape may, nj 08204</city_state_zip><phone>609827-3309</phone><email/><emergency_contact>garry gilbert</emergency_contact><emergency_phone_>609-827-4455</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>current boot camper</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>robin s.gilbert</2></root> 2009-12-13T20:45:17-06:00 2128 151781 2009-12-13T20:45:17-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danielle Cloud</name><address>71 Wescott Road </address><city_state_zip>NJ</city_state_zip><phone>609 6240324</phone><email>dcloud3@hotmail.com</email><emergency_contact>609 6240324</emergency_contact><emergency_phone_>609 6240324</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>ACL reconstructive surgery 2 years ago and currently have no limitations</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Danielle Cloud</2></root> 2009-12-11T21:48:57-06:00 2128 150971 2009-12-11T21:48:57-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Brigitte Glynn</name><address>134 Woodbine Ocean View Rd</address><city_state_zip>Ocean View, NJ 08230</city_state_zip><phone>267-250-6998</phone><email>nursebrigmc@yahoo.com</email><emergency_contact>Paul Glynn</emergency_contact><emergency_phone_>609-602-8277</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Brigitte Glynn</2></root> 2009-12-10T20:48:27-06:00 2128 150601 2009-12-10T20:48:27-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lauren Piacentine</name><address>902 Shunpike Road</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>6098276287</phone><email>lgp22@msn.com</email><emergency_contact>Shawn Laughlin</emergency_contact><emergency_phone_>6093747625</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>nick... i wanted to get my name on the list in case it sells out. i will stop in early next week to pay. thanks! lauren p.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lauren Piacentine</2></root> 2009-12-10T09:39:25-06:00 2128 150111 2009-12-10T09:39:25-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Katy Sudell</name><address>2789 Dune Drive</address><city_state_zip>Avalon, NJ 08202</city_state_zip><phone>609-425-0310</phone><email>kss@fdrealestate.com</email><emergency_contact>Jayne Sudell</emergency_contact><emergency_phone_>609-465-5444</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hey Nick and Joe, If there&apos;s still space available for Joe&apos;s Boot Camp on TUES/THURS at 6pm I&apos;d like to sign up. I really like this format and Joe does a great job coordinating such a large class in a short amount of time. I get a great workout and I&apos;m trying to encourage some of the people in my own classes to join a session. </please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Katy Sudell</2></root> 2009-12-09T08:29:26-06:00 2128 149461 2009-12-09T08:29:26-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tracey Eppright</name><address>104 Birch Drive</address><city_state_zip>Swainton, NJ 08210</city_state_zip><phone>609-463-8254 204-3921</phone><email>teppright@verizon.net</email><emergency_contact>Laurence Eppright</emergency_contact><emergency_phone_>231-5181</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Nick, Please let me know if there is still availability for the January 4th session.... Thanks...see you soon</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tracey Eppright</2></root> 2009-12-08T10:11:41-06:00 2128 149091 2009-12-08T10:11:41-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lois and Allison hellmig</name><address>5 pine hollow ct</address><city_state_zip>Cape may court house nj 08210</city_state_zip><phone>609 827 0768</phone><email>Lhellmig@aol.com</email><emergency_contact>Gary hellmig</emergency_contact><emergency_phone_>856 906 9895</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Hi nick Allie and I r on vacation. We&apos;ll b backnext mon. Just wanted to get signed up early. Thanks. Lois. a</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lois hellmig</2></root> 2009-12-07T19:34:58-06:00 2128 148541 2009-12-07T19:34:58-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debbie Greene</name><address>25 Mimosa Dr</address><city_state_zip>Rio Grande NJ 08242</city_state_zip><phone>408-6800</phone><email>greene_debbie@yahoo.com</email><emergency_contact>Pat Greene</emergency_contact><emergency_phone_>408-6801</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deborah Greene</2></root> 2009-12-07T15:44:17-06:00 2128 148461 2009-12-07T15:44:17-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer Player</name><address>515 Fidler Hill Rd</address><city_state_zip>Woodbine, NJ, 08270</city_state_zip><phone>609-408-1924</phone><email>player_jennifer@yahoo.com</email><emergency_contact>Jane Player</emergency_contact><emergency_phone_>609-442-1707</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jennifer Player</2></root> 2009-12-07T10:56:49-06:00 2128 148131 2009-12-07T10:56:49-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Christina Kobielnik</name><address>33 Lola Ln</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-827-3921</phone><email>gras23@hotmail.com</email><emergency_contact>Chris Kobielnik</emergency_contact><emergency_phone_>609-827-9249</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Please put me on the list for January 4, 2010. I will be back (2 days a week) M-W 5:30-6:30. I have been on a financial hiatus. Thanks- Christina Kobielnik </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Christina Grassi-Kobielnik</2></root> 2009-12-06T10:37:34-06:00 2128 147661 2009-12-06T10:37:34-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Moncia M. DiVito</name><address>895 Towerview Road</address><city_state_zip>Erma, NJ 08204</city_state_zip><phone>(609)889-2732</phone><email/><emergency_contact>Michael J. DiVito</emergency_contact><emergency_phone_>609-827-7180</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Already in Boot Camp. Want to reserve space early since January will be a busy month!!</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Monica M. DiVito</2></root> 2009-12-05T21:38:44-06:00 2128 147491 2009-12-05T21:38:44-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danielle DeGeorge</name><address>414 Petersburg Rd</address><city_state_zip>Dennisville, NJ, 08214</city_state_zip><phone>609 602-4403</phone><email>danielle_cristin@hotmail.com</email><emergency_contact>Debbie DeGeorge</emergency_contact><emergency_phone_>609 602 4401</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Danielle DeGeorge</2></root> 2009-12-04T13:09:43-06:00 2128 146911 2009-12-04T13:09:43-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marie Floria</name><address>608 Tidewater road</address><city_state_zip>rio grande, nj 08242</city_state_zip><phone>609-889-0857</phone><email/><emergency_contact>Ron Floria</emergency_contact><emergency_phone_>215-262-7711 </emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am a current client and am signing up to reserve my spot for Jan 4th</please_explain><do_you_have_any_known_cardiovascular_problems>non-sustained VT</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Marie Floria</2></root> 2009-12-02T12:11:29-06:00 2128 145211 2009-12-02T12:11:29-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Linda Babbitt</name><address>1175 Delsea Drive</address><city_state_zip>Woodbine, NJ 08270</city_state_zip><phone>861-5966</phone><email>lmbabbitt@comcast.net</email><emergency_contact>Scott Babbitt</emergency_contact><emergency_phone_>609-780-5002</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Linda Babbitt</2></root> 2009-11-30T20:16:05-06:00 2128 144321 2009-11-30T20:16:05-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Stephanie Zimmer</name><address>203 Lennox Ave </address><city_state_zip>Cape May, NJ, 08204</city_state_zip><phone>856-816-2474</phone><email>zimmers@lcmrschools.com</email><emergency_contact>Brett Matthews</emergency_contact><emergency_phone_>609 408 3391</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Stephanie Zimmer</2></root> 2009-11-30T20:15:37-06:00 2128 144311 2009-11-30T20:15:37-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Meghan Ludgate</name><address>17 West Timber Ln</address><city_state_zip>Palermo, NJ 08223</city_state_zip><phone>609-425-7265</phone><email/><emergency_contact>856-816-2474</emergency_contact><emergency_phone_>609-390-2049</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>mvludgate</2></root> 2009-11-30T11:15:11-06:00 2128 143521 2009-11-30T11:15:11-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Stacey Karanozinsky</name><address>8208 Central Avenue</address><city_state_zip>Sea Isle City, NJ 08243</city_state_zip><phone>609-338-8149</phone><email>a.s.k@comcast.net</email><emergency_contact>Andy Karanozinsky</emergency_contact><emergency_phone_>609-408-4752</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Just spoke with Nick about joining the class</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>Yes. Currently BP is fine. </has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Prenatal vitamins</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Stacey Karanozinsky</2></root> 2009-11-29T07:05:24-06:00 2128 142991 2009-11-29T07:05:24-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jacquelyn Senico</name><address>9 Moore Terrace</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>6094630632</phone><email>jacquesenico@yahoo.com</email><emergency_contact>Daniel Senico</emergency_contact><emergency_phone_>6098272089</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jacquelyn Senico</2></root> 2009-11-23T11:02:14-06:00 2128 139921 2009-11-23T11:02:14-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kristy Thall</name><address>225 E. 2nd Ave.</address><city_state_zip>N. Wildwood, NJ, 08260</city_state_zip><phone>609-846-6997</phone><email/><emergency_contact>Maureen Thall</emergency_contact><emergency_phone_>609-522-2030 ext 1430</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kristy Thall</2></root> 2009-11-21T18:20:36-06:00 2128 138741 2009-11-21T18:20:36-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marsha Gephart</name><address>214 Laurel Drive</address><city_state_zip>Marmora, NJ 08223</city_state_zip><phone>609-233-4185</phone><email>magephart@comcast.net</email><emergency_contact>Walter Gephart</emergency_contact><emergency_phone_>609-675-8888</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>vitamins</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Marsha Gephart</2></root> 2009-11-21T08:44:38-06:00 2128 138551 2009-11-21T08:44:38-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>ALLISON WIGGLESWORTH</name><address>208 FREDERICK AVE</address><city_state_zip>MARMORA NJ 08213</city_state_zip><phone>609-545-0683</phone><email>fillingmarble@aol.com</email><emergency_contact>JOHN RATTIGAN</emergency_contact><emergency_phone_>609-338-1880</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>ALLISON WIGGLESWORTH</2></root> 2009-11-21T08:42:47-06:00 2128 138541 2009-11-21T08:42:47-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>PAT WIGGLESWORTH</name><address>208 FREDERICK AVE</address><city_state_zip>MARMORA</city_state_zip><phone>609-545-0683</phone><email>fillingmarble@aol.com</email><emergency_contact>John Rattigan</emergency_contact><emergency_phone_>609-338-1880</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>PAT WIGGLESWORTH</2></root> 2009-11-21T08:27:37-06:00 2128 138531 2009-11-21T08:27:37-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Maryaurelia Newlin</name><address>1608 Central Avenue Unit #15</address><city_state_zip>North Wildwood, NJ 08260</city_state_zip><phone>215 915 6000</phone><email>newlin@avaya.com</email><emergency_contact>Jonathan Goodroe</emergency_contact><emergency_phone_>609 780 4565</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Saw a comment on Facebook from one of your current Members: Josette Goodroe</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Maryaurelia Newlin</2></root> 2009-11-21T08:27:36-06:00 2128 138521 2009-11-21T08:27:36-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Maryaurelia Newlin</name><address>1608 Central Avenue Unit #15</address><city_state_zip>North Wildwood, NJ 08260</city_state_zip><phone>215 915 6000</phone><email>newlin@avaya.com</email><emergency_contact>Jonathan Goodroe</emergency_contact><emergency_phone_>609 780 4565</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Saw a comment on Facebook from one of your current Members: Josette Goodroe</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Maryaurelia Newlin</2></root> 2009-11-20T09:32:13-06:00 2128 137921 2009-11-20T09:32:13-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Ann DeGennaro</name><address>27 Island View Terrace</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-338-8219</phone><email>a.degennaro@yahoo.com</email><emergency_contact>Paul DeGennaro</emergency_contact><emergency_phone_>390-1339, 315-3007</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Nick, I was unable to make three classes last session, is it possible to get credit for them? Ann DeGennaro</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Ann DeGennaro</2></root> 2009-11-20T08:30:27-06:00 2128 137911 2009-11-20T08:30:27-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Alison Heller</name><address>111 A W Syracuse Ave</address><city_state_zip>Wildwood Crest NJ 08260</city_state_zip><phone>609-408-6709</phone><email>alisonheller7@gmail.com</email><emergency_contact>Justin Vitti</emergency_contact><emergency_phone_>609-224-9061</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Alison Heller</2></root> 2009-11-19T16:44:21-06:00 2128 137701 2009-11-19T16:44:21-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Michelle Majewski</name><address>14 East Miami Avenue </address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-374-6002</phone><email/><emergency_contact>Frank Majewski</emergency_contact><emergency_phone_>609-374-6001</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Michelle Majewski</2></root> 2009-11-19T16:25:37-06:00 2128 137691 2009-11-19T16:25:37-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>leila</name><address>reevey</address><city_state_zip>marmora, nj 08223</city_state_zip><phone>6093900338</phone><email/><emergency_contact>catherine streckenbein</emergency_contact><emergency_phone_>6092263986</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>celexa-depression and seroquil depression</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>leila r reevey</2></root> 2009-11-19T16:21:04-06:00 2128 137681 2009-11-19T16:21:04-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Michelle Majewski</name><address>14 East Miami Avenue </address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-374-6002</phone><email/><emergency_contact>Frank Majewski</emergency_contact><emergency_phone_>609-374-6001</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Michelle Majewski</2></root> 2009-11-19T16:09:26-06:00 2128 137661 2009-11-19T16:09:26-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Amy Albee</name><address>463 Shunpike Road</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-972-6611</phone><email>jftlovelife87@hotmail.com</email><emergency_contact>Amanda Albee</emergency_contact><emergency_phone_>609-972-6311</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>I am taking Orthro which is birth control.</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Amy Albee</2></root> 2009-11-19T14:53:13-06:00 2128 137631 2009-11-19T14:53:13-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Amy Beth Britner</name><address>224 W. Wilde Ave </address><city_state_zip>Villas NJ 08251</city_state_zip><phone>609-770-3044</phone><email>blondiebrit44@aol.com</email><emergency_contact>Vincent Maggi</emergency_contact><emergency_phone_>609-231-8131</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am not in good shape. Can I still do the boot camp? </please_explain><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Amy Beth Britner</2></root> 2009-11-19T08:43:12-06:00 2128 137491 2009-11-19T08:43:12-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Donna Blackley</name><address>899 Weeks Landing Road</address><city_state_zip>Erma, NJ 08204</city_state_zip><phone>609-780-1337</phone><email>jdblackley@comcast.net</email><emergency_contact>Jay Blackley</emergency_contact><emergency_phone_>609-780-4274</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Donna Blackley</2></root> 2009-11-16T09:14:36-06:00 2128 136311 2009-11-16T09:14:36-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lori Schulte</name><address>204 Del Val Rd.</address><city_state_zip>Cape May Court House NJ</city_state_zip><phone>609 425-8006</phone><email>lorischulte@mac.com</email><emergency_contact>Paul Schulte</emergency_contact><emergency_phone_>609 425-8007</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Hey Nick, I&apos;m bringing up the check later today. Lori</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lori Schulte</2></root> 2009-11-15T19:34:57-06:00 2128 136171 2009-11-15T19:34:57-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Amanda Caroccio</name><address>8 Peach Orchard Road</address><city_state_zip>Seaville, NJ, 08230</city_state_zip><phone>609-425-4657</phone><email>PrincessAmanda85@aol.com</email><emergency_contact>Patricia Caroccio</emergency_contact><emergency_phone_>609-675-1577</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Amanda Caroccio</2></root> 2009-11-15T09:09:39-06:00 2128 136041 2009-11-15T09:09:39-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Vicki Peterson</name><address>343 Gracetown Road</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-827-4785</phone><email>evzpete@comcast.net</email><emergency_contact>Eric Peterson, Paula Smith</emergency_contact><emergency_phone_>609-408-5608, 609-231-9117</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Paula Smith, a current Boot Camper, highly recommends your program</please_explain><do_you_have_any_known_cardiovascular_problems>none</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>lipitor, 20mg high cholesterol</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Vicki Peterson</2></root> 2009-11-14T19:39:56-06:00 2128 135901 2009-11-14T19:39:56-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Karin Procaccino</name><address>2488 Dune Drive</address><city_state_zip>Avalon, NJ 08202</city_state_zip><phone>609.742.5464</phone><email>molsonridge@hotmail.com</email><emergency_contact>Judy Davies</emergency_contact><emergency_phone_>609.425.4670</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I would like to participate in the next boot camp session beginning Monday, November 23rd. However, due to grad class I will be unable to attend class on the 23rd, but will definitely begin on Wednesday, November 25th. My friend, Judy Davies recently joined your boot camp and she has highly recommended it! I&apos;m extremely excited to start! </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Karin S. Procaccino</2></root> 2009-11-14T10:58:21-06:00 2128 135761 2009-11-14T10:58:21-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Edie Gentilini</name><address>62 Suttons Lane</address><city_state_zip>Eldora, NJ 08270</city_state_zip><phone>609-861-1006</phone><email>ediegentilini@yahoo.com</email><emergency_contact>Don Gentilini</emergency_contact><emergency_phone_>609-861-0100</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>edie gentilini</2></root> 2009-11-13T19:08:54-06:00 2128 135611 2009-11-13T19:08:54-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Roseanne Martino</name><address>320 E. Topeka Ave</address><city_state_zip>Wildwood Crest,nj, 08260</city_state_zip><phone>6095226296</phone><email>rmartino21@yahoo.com</email><emergency_contact>robert dailey</emergency_contact><emergency_phone_>6096754822</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Roseane Martino</2></root> 2009-11-13T19:07:18-06:00 2128 135601 2009-11-13T19:07:18-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Nicole Bounsis</name><address>320 E. Topeka ave.</address><city_state_zip>wildwood crest, nj,08260</city_state_zip><phone>609522696</phone><email>nbounasis22@yahoo.com</email><emergency_contact>Roseanne martino</emergency_contact><emergency_phone_>6096024349</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Nicole Bounasis</2></root> 2009-11-13T09:33:42-06:00 2128 135181 2009-11-13T09:33:42-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Chelsea Rekuc</name><address>13 Dory Drive</address><city_state_zip>CMCH, NJ, 08210</city_state_zip><phone>6096751432</phone><email>chelsearekuc@yahoo.com</email><emergency_contact>sherry</emergency_contact><emergency_phone_>6092332233</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>chelsea rekuc</2></root> 2009-11-13T08:30:31-06:00 2128 135121 2009-11-13T08:30:31-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Megan Hoppe</name><address>315 East Delaware Pkwy</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-846-7314</phone><email>hoppe_88@yahoo.com</email><emergency_contact>Stephen Hoppe</emergency_contact><emergency_phone_>609-972-5235</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Megan Hoppe</2></root> 2009-11-12T17:16:43-06:00 2128 134931 2009-11-12T17:16:43-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>veronica leider</name><address>39 somers ave</address><city_state_zip>oceanview nj 08230</city_state_zip><phone>6093746066</phone><email>veronicaleider@hotmail.com</email><emergency_contact>ron leider</emergency_contact><emergency_phone_>6097800286</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hello Nick, Spoke to you on the phone a few minutes ago about joining the seaville bootcamp. Per conversation i will be starting friday the 13th at 6:30 p.m. with a pro rate of 40.00 dollars for the remaining sessions. Is the membership good for the rio gym as well? As far as the boot camp if i were in rio which is where i work would i be able to vary with my class choice ? Thanks for your time Veronica Leider</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Liptor for cholestrol</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Veronica Leider</2></root> 2009-11-09T13:18:00-06:00 2128 133731 2009-11-09T13:18:00-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Aubree Hand</name><address>9002 Second ave </address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>609-231-3707</phone><email>alhand529@gmail.com</email><emergency_contact>JP Hand</emergency_contact><emergency_phone_>609-231-6611</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I had paid to attend boot camp in October and then had a severe accident and was not able to walk around, let alone work out for 3 weeks. I was hoping I could move my payment to start this month if possible because I just got the doctor&apos;s okay to start working out again. Please let me know!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>yes, burns to my feet that have healed completely, and I have the doctor&apos;s okay to work out again</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Aubree Hand</2></root> 2009-11-05T15:48:55-06:00 2128 132121 2009-11-05T15:48:55-06:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Julia Grassi</name><address>210 East Rosemary Road</address><city_state_zip>Wildwood Crest, NJ 08260</city_state_zip><phone>609 675 1217</phone><email>jul4134@hotmail.com</email><emergency_contact>Kate Grassi</emergency_contact><emergency_phone_>609 675 6680 609 729 4134</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Julia Grassi</2></root> 2009-10-30T10:30:34-05:00 2128 130231 2009-10-30T10:30:34-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tracie Cicchitti</name><address>843 Cape Avenue</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>6096751160</phone><email>traciefinn@verizon.net</email><emergency_contact>James Cicchitti</emergency_contact><emergency_phone_>6097801301</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>The Herald and through Andrea Maher. In fact, she gave me a 25% off card. I spoke to Nick this morning...there was a mix up, and I never got a call back to start this past week. He said I could start on Monday, November 2.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Levothyroxine- thyroid problems, Wellbutrin- depression, </are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>finished chemo-a year ago and haven&apos;t been able to lose the weight I gained or get in shape</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tracie Cicchitti</2></root> 2009-10-29T09:06:00-05:00 2128 129961 2009-10-29T09:06:00-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susan Cawley</name><address>109 E. Central Ave</address><city_state_zip>CMCH NJ 08210</city_state_zip><phone>609-602-4760</phone><email>susancawley@comcast.net</email><emergency_contact>Ted Cawley</emergency_contact><emergency_phone_>609-602-4759</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Nick, I&apos;d like to register for the Rio MWF 7:30am session and start 11/2, but I have one concern - my work schedule at times requires me to be in early on Monday morning. Is it possible, if necessary, to attend a Monday night camp on those occassions? Thank you, Sue Cawley</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No </are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>Exercise induced asthma - treated with inhaler prior to exertion. </do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susan Cawley</2></root> 2009-10-28T13:41:14-05:00 2128 129791 2009-10-28T13:41:14-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Anita McMahon</name><address>3 Staples Court</address><city_state_zip>Beesleys Point</city_state_zip><phone>609-390-4769</phone><email>a_mcmahon@hotmail.com</email><emergency_contact>Bill-husband</emergency_contact><emergency_phone_>609-408-5841</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I just spoke with Nick. He said that for this session, it&apos;s possible for me to pay per class ($10). </please_explain><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Anita McMahon</2></root> 2009-10-27T21:10:43-05:00 2128 129601 2009-10-27T21:10:43-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kara L Krafczek</name><address>10017 Sunset Drive</address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>609-408-6855</phone><email>karakrafczek@comcast.net</email><emergency_contact>Charles Krafczek</emergency_contact><emergency_phone_>609-408-6799</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>2 day Boot Camp (M &amp; F 9:30 a.m.) talked to Nick this evening will pay tomorrow morning at the gym. Thank you! </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kara L Kraczek</2></root> 2009-10-27T13:56:48-05:00 2128 129451 2009-10-27T13:56:48-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Christina Hagan</name><address>105 Wistar Avenue</address><city_state_zip>Marmora NJ 08223</city_state_zip><phone>6095766004</phone><email/><emergency_contact>Michael Tolson</emergency_contact><emergency_phone_>6096027777</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am very interested in the PAC Boot Camp when the next sessions are available. I have been trying to get back into going to the gym; however I think being in a group atmosphere would motivate me more than going to the gym on my own. </please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Christina Hagan</2></root> 2009-10-26T20:06:46-05:00 2128 129151 2009-10-26T20:06:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Wendy Brown</name><address>P.O.Box 394</address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>1-609-741-0925</phone><email>wmbjerseyshore@hotmail.com</email><emergency_contact>Nick Konides</emergency_contact><emergency_phone_>1-609-425-0179</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>When does the next session begin and is there a waiting list?</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Wendy Brown</2></root> 2009-10-25T16:26:11-05:00 2128 128461 2009-10-25T16:26:11-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kate Sherman</name><address>103 Hand Ave.</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-536-2673</phone><email/><emergency_contact>Bob Moran</emergency_contact><emergency_phone_>609-675-8665</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I&apos;ve done the classes before. If there&apos;s room in this particular session, can someone give me a call to confirm my spot, please? Thanks a lot.</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kate Sherman</2></root> 2009-10-25T13:50:32-05:00 2128 128381 2009-10-25T13:50:32-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Meaghan Schweibinz</name><address>1305 Massachusetts Ave.</address><city_state_zip>CMCH NJ 08210</city_state_zip><phone>609-827-0580</phone><email>mschweibinz@yahoo.com</email><emergency_contact>Missy Kirkbride</emergency_contact><emergency_phone_>609-780-7140</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Yaz, BC pill</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Meaghan L. Schweibinz</2></root> 2009-10-24T20:38:15-05:00 2128 128221 2009-10-24T20:38:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Robin Loggi</name><address>14 Harrys Ct</address><city_state_zip>Ocean View, NJ 098230</city_state_zip><phone>390-7629</phone><email>rllupine@aol.com</email><emergency_contact>Dan</emergency_contact><emergency_phone_>390-7629</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Yes </are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Robin Loggi</2></root> 2009-10-24T20:13:59-05:00 2128 128201 2009-10-24T20:13:59-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>jenny hansen</name><address>7 harrys court</address><city_state_zip>ocean view nj 08230</city_state_zip><phone>6093900522</phone><email>wedocs@comcast.net</email><emergency_contact>cell 4254610</emergency_contact><emergency_phone_>cell 4254610</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I can only make it for wed and fridays .. due to work schedule.. would i get the $99 rate if I can only make 2 days/ week? thank you... </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>jenny hansen</2></root> 2009-10-23T14:29:16-05:00 2128 127921 2009-10-23T14:29:16-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Gina Bailey</name><address>11 Brewhaus Lane</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-602-8349</phone><email>red4674@hotmail.com</email><emergency_contact>Nick Bailey</emergency_contact><emergency_phone_>609-289-7474</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Gina Bailey</2></root> 2009-10-23T06:53:31-05:00 2128 127561 2009-10-23T06:53:31-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tracie cicchitti</name><address>843 Cape Avenue</address><city_state_zip>Cape May</city_state_zip><phone>6098980827</phone><email>traciefinn@verizon.net</email><emergency_contact>James Cicchitti</emergency_contact><emergency_phone_>6097801301</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I have been thinking about this since last January, but I never could get up the courage to try it. But, I am going to take the plunge now.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>levothyroxine-thyroid &amp; bupropion-depression</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tracie Cicchitti</2></root> 2009-10-22T20:31:37-05:00 2128 127511 2009-10-22T20:31:37-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Angela Schweibinz</name><address>1181 Tyler Rd</address><city_state_zip>Woodbine, Nj 08270</city_state_zip><phone>609 425 1540</phone><email>schweibinzfarm@yahoo.com</email><emergency_contact>James Schweibinz</emergency_contact><emergency_phone_>609 780 2414</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Angela Schweibinz</2></root> 2009-10-22T14:40:44-05:00 2128 127401 2009-10-22T14:40:44-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Avril JonassaintCathie</name><address>1910 Route 9 South</address><city_state_zip>Whitesboro, NJ 08252</city_state_zip><phone>6098270558</phone><email>ajcathie@yahoo.com</email><emergency_contact>Cecil Cathie</emergency_contact><emergency_phone_>6092313422</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Avril JonassaintCathie</2></root> 2009-10-22T14:30:53-05:00 2128 127391 2009-10-22T14:30:53-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jodie Schweibinz</name><address>1181 Tyler Rd</address><city_state_zip>Woodbine, NJ</city_state_zip><phone>609-827-2495</phone><email>jodieschweibinz@yahoo.com</email><emergency_contact>angela schweibinz</emergency_contact><emergency_phone_>609-425-1540</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hi, I am planning to take the class in rio grande with co-workers, however i can only attend class MW, and every other friday, will this hinder results, Is it still worth signing up? Hope to hear from you soon! Thanks, Jodie Schweibinz</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jodie Schweibinz</2></root> 2009-10-22T13:18:19-05:00 2128 127341 2009-10-22T13:18:19-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Bonny J Werntz</name><address>165 woodbine blvd</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-425-0586</phone><email>luvmy2kids1@comcast.net</email><emergency_contact>Sue Payne</emergency_contact><emergency_phone_>609-965-4018</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I already spoke with Nick about joining this class earlier today.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Bonny Werntz</2></root> 2009-10-22T09:45:31-05:00 2128 127191 2009-10-22T09:45:31-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debbie Greene</name><address>25 Mimosa Dr</address><city_state_zip>Rio Grande NJ 08242</city_state_zip><phone>408-6800</phone><email>greene_debbie@yahoo.com</email><emergency_contact>Patrick Greene</emergency_contact><emergency_phone_>408-6801</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Nick, I have tried to e-mail you several times and I haven&apos;t heard back from you. I wanted to know if I could join the Tues and Thurs class from 5-6pm to make up about 10 classes that I missed from the Mon - Wed - Fri classes that I missed because of me and my family being sick. Please let me know. I will see you Tues. Thanks, Debbie You can reach me at 465-1019</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deborah Greene</2></root> 2009-10-21T19:04:12-05:00 2128 127021 2009-10-21T19:04:12-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Michelle Chambers</name><address>220 E 24th Ave</address><city_state_zip>N Wildwood, NJ 08260</city_state_zip><phone>8563975117</phone><email>maxonthebeach@comcast.net</email><emergency_contact>Scott Chambers</emergency_contact><emergency_phone_>6098202840</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Michelle M Chambers</2></root> 2009-10-21T14:37:43-05:00 2128 126891 2009-10-21T14:37:43-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Shellee Henson Reed</name><address>208 Frances ave</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>1-856-287-3272 Cell #</phone><email>shelleehenson@yahoo.com</email><emergency_contact>Jasper Reed</emergency_contact><emergency_phone_>609-425-5512</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am resending this form. I sent it before Amelia Fasciano and she received a call already. I thought maybe it did not go through the first time. Thanks </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Shellee Henson Reed</2></root> 2009-10-21T14:00:23-05:00 2128 126851 2009-10-21T14:00:23-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Amelia</name><address>Fasciano</address><city_state_zip>Cape May Court House</city_state_zip><phone>609-846-5717</phone><email/><emergency_contact>Judy</emergency_contact><emergency_phone_>609-463-8980</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Amelia Fasciano</2></root> 2009-10-21T13:58:05-05:00 2128 126841 2009-10-21T13:58:05-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>shellee henson reed</name><address>208 frances ave</address><city_state_zip>villas, nj 08251</city_state_zip><phone>856-287-3272</phone><email>shelleehenson@yahoo.com</email><emergency_contact>jasper reed</emergency_contact><emergency_phone_>609-425-5512</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>shellee henson reed</2></root> 2009-10-21T08:40:00-05:00 2128 126611 2009-10-21T08:40:00-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Carriann Isman Knoedler</name><address>11 Saint Andrews Place</address><city_state_zip>Marmora, NJ 08223</city_state_zip><phone>609-442-8676</phone><email>carriann08221@aol.com</email><emergency_contact>Scott Knoedler</emergency_contact><emergency_phone_>609-254-6210</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Herald &amp; Word of Mouth</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Amitiza-IBS</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>minor asthma</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Carriann Isman Knoedler</2></root> 2009-10-21T08:36:07-05:00 2128 126591 2009-10-21T08:36:07-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Barbara White</name><address>103 Edna ave</address><city_state_zip>villas, nj 08251</city_state_zip><phone>609-334-6412</phone><email>bwhite499@gmail.com</email><emergency_contact>Stephen White</emergency_contact><emergency_phone_>609-886-5922</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I would like to join the co-ed session with my husband Steve White on Tuesdays and Thursdays from 5pm-6pm. Thank you Can we join the next session on Oct 26th? How much is it for both of us? Barbara White</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Barbara White</2></root> 2009-10-20T13:47:23-05:00 2128 126431 2009-10-20T13:47:23-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marcie Samartino</name><address>206 w pittsburgh ave</address><city_state_zip>wildwood crest nj 08260</city_state_zip><phone>6097297626</phone><email>marcies9@comcast.net</email><emergency_contact>anthony samartino</emergency_contact><emergency_phone_>6094255296</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>allegra d flonase for sinuses</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>marcie samartino</2></root> 2009-10-19T10:51:47-05:00 2128 125951 2009-10-19T10:51:47-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susan Arpa</name><address>108 Delair Road</address><city_state_zip>Townbank, NJ 08204</city_state_zip><phone>608-886-4158</phone><email>sarpa@comcast.net</email><emergency_contact>Lou Arpa - Husband</emergency_contact><emergency_phone_>609-827-3365</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Herald. </please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Plantar Fascitis - currently healed 85%, Also Back and Neck problems - currently stable. </do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susan A Arpa</2></root> 2009-10-15T12:31:07-05:00 2128 125181 2009-10-15T12:31:07-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Stacey Karanozinsky</name><address>8208 Central Avenue</address><city_state_zip>Sea Isle City, NJ 08243</city_state_zip><phone>609-338-8149</phone><email>a.s.k@comcast.net</email><emergency_contact>Andy Karanozinsky</emergency_contact><emergency_phone_>609-408-4752</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I&apos;m already a member of Miracles and I am interested in the Boot Camp Program. </please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes. I was no medication a few years ago but right now I do not take anything and I monitor my BP at home. </has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>pre-natal vitamins although I am not pregnant yet</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>high cholestrol but when off meds per physician since we want to start a family</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Stacey Karanozinsky</2></root> 2009-10-13T10:13:23-05:00 2128 123921 2009-10-13T10:13:23-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>kimberly servis</name><address>1076 pamela dr</address><city_state_zip>stone harbor, nj 08247</city_state_zip><phone>609-575-2867</phone><email>kbuck123@aol.com</email><emergency_contact>john fulton</emergency_contact><emergency_phone_>609-408-7227</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>protonix- ulcers</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>kimberly servis</2></root> 2009-10-13T09:40:46-05:00 2128 123901 2009-10-13T09:40:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Denise Stehman</name><address>34 Solar Way</address><city_state_zip>CMCH, NJ</city_state_zip><phone>609-602-2470</phone><email>solarway34@comcast.net</email><emergency_contact>Chris Stehman</emergency_contact><emergency_phone_>609-425-7646</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Hi Nick, I did boot camp last winter and spring and am interested in starting again in Nov, I am available to start Nov 9 Thanks</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>yes, thyroid</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Denise Stehman</2></root> 2009-10-12T19:49:48-05:00 2128 123761 2009-10-12T19:49:48-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melissa Arena</name><address>1361A Vermont Avenue</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-898-8105</phone><email>lissa_arena@yahoo.com</email><emergency_contact>Frank Arena</emergency_contact><emergency_phone_>732-433-4411</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I spoke with Nick today (10/12/09) and he said it was okay for me to start late on Wednesday, 10/14/09. Thanks. Melissa</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No, just vitamins</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>I have some neck issues and I go to a chiropractor 1x a month </do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melissa Arena</2></root> 2009-10-07T13:50:18-05:00 2128 121881 2009-10-07T13:50:18-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Pauline Levy</name><address>6300 Pacific Ave</address><city_state_zip>Wildwood Crest, NJ 08260</city_state_zip><phone>609-522-4374</phone><email>pa.le@verizon.net</email><emergency_contact>Valerie Driscoll </emergency_contact><emergency_phone_>609-780-5462</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>left knee, torn medial meniscus several years ago</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Pauline Levy</2></root> 2009-09-30T12:30:21-05:00 2128 119261 2009-09-30T12:30:21-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>jame martin</name><address>78 millman blvd</address><city_state_zip>del haven, nj 08251</city_state_zip><phone>301-801-5751</phone><email>jamie.j.martin@uscg.mil</email><emergency_contact>Brian Martin</emergency_contact><emergency_phone_>609-618-4175</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>jamie martin</2></root> 2009-09-29T11:22:44-05:00 2128 118631 2009-09-29T11:22:44-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Karen Hoffman</name><address>324 Dock Street</address><city_state_zip>Wildwood, NJ</city_state_zip><phone>609-408-7418</phone><email>Khffmn1@verizon.net</email><emergency_contact>Paul Hoffman</emergency_contact><emergency_phone_>609-522-5112</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>in past, not now</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>karen Hoffman</2></root> 2009-09-26T10:44:48-05:00 2128 117911 2009-09-26T10:44:48-05:00 <root><i_am_interested_in>Personal Training</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>nicolette tomes</name><address>4 e miami ave</address><city_state_zip>villas, nj, 08251</city_state_zip><phone>1609-972-5223</phone><email>nikkitomes13@yahoo.com</email><emergency_contact>tom</emergency_contact><emergency_phone_>609-548-4493</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>nicolette m tomes</2></root> 2009-09-26T10:36:34-05:00 2128 117901 2009-09-26T10:36:34-05:00 <root><i_am_interested_in>Personal Training</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>nicolette tomes</name><address>4 e miami ave</address><city_state_zip>villas, nj, 08251</city_state_zip><phone>1609-972-5223</phone><email>nikkitomes13@yahoo.com</email><emergency_contact>tom</emergency_contact><emergency_phone_>609-548-4493</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>nicolette m tomes</2></root> 2009-09-25T13:40:58-05:00 2128 117701 2009-09-25T13:40:58-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lorin Payton</name><address>P.O. Box 51</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>267-939-9030</phone><email>lorilynnpm@yahoo.com</email><emergency_contact>Lindsey Zinck</emergency_contact><emergency_phone_>215-833-7936</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Did SH &quot;Booty&quot; Camp this summer!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>5 stomach surgeries (3 C-sections/2 Hernia repairs)</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lorin Payton</2></root> 2009-09-25T13:40:27-05:00 2128 117691 2009-09-25T13:40:27-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lorin Payton</name><address>P.O. Box 51</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>267-939-9030</phone><email>lorilynnpm@yahoo.com</email><emergency_contact>Lindsey Zinck</emergency_contact><emergency_phone_>215-833-7936</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Did SH &quot;Booty&quot; Camp this summer!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>5 stomach surgeries (3 C-sections/2 Hernia repairs)</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lorin Payton</2></root> 2009-09-25T13:39:21-05:00 2128 117681 2009-09-25T13:39:21-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lorin Payton</name><address>P.O. Box 51</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>267-939-9030</phone><email>lorilynnpm@yahoo.com</email><emergency_contact>Lindsey Zinck</emergency_contact><emergency_phone_>215-833-7936</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Did SH &quot;Booty&quot; Camp this summer!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>5 stomach surgeries (3 C-sections/2 Hernia repairs)</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lorin Payton</2></root> 2009-09-25T13:39:19-05:00 2128 117671 2009-09-25T13:39:19-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lorin Payton</name><address>P.O. Box 51</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>267-939-9030</phone><email>lorilynnpm@yahoo.com</email><emergency_contact>Lindsey Zinck</emergency_contact><emergency_phone_>215-833-7936</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Did SH &quot;Booty&quot; Camp this summer!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>5 stomach surgeries (3 C-sections/2 Hernia repairs)</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lorin Payton</2></root> 2009-09-25T12:28:23-05:00 2128 117621 2009-09-25T12:28:23-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melissa Zarharchuck</name><address>22 Priest Blvd.</address><city_state_zip>Rio Grande, NJ,08242</city_state_zip><phone>609-827-5255</phone><email>minipearl13@comcast.net</email><emergency_contact>Jill Zarharchuck </emergency_contact><emergency_phone_>609-408-7921</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Prozac for depression and OCD.</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melissa Zarharchuck </2></root> 2009-09-24T07:01:48-05:00 2128 117201 2009-09-24T07:01:48-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>annefrances benichou</name><address>301 east 24th avenue</address><city_state_zip>northwildwood, nj, 08260</city_state_zip><phone>609-523-9192</phone><email>annefrances77@hotmail.com</email><emergency_contact>simon benichou</emergency_contact><emergency_phone_>609-972-9128</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>annefrances benichou</2></root> 2009-09-22T17:12:01-05:00 2128 116801 2009-09-22T17:12:01-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Aubree Hand</name><address>9002 Second Avenue</address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>6092313707</phone><email>alhand529@gmail.com</email><emergency_contact>JP Hand</emergency_contact><emergency_phone_>6092316611</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Aubree Hand</2></root> 2009-09-21T18:16:27-05:00 2128 115731 2009-09-21T18:16:27-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>MARIANN MOHEB</name><address>208 E. HILDRETH AVE</address><city_state_zip>WILDWOOD, NJ 08260</city_state_zip><phone>856-381-9909</phone><email/><emergency_contact>ANGELO VALENTE</emergency_contact><emergency_phone_>856-981-9909</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>HIGH PRESSURE NEED EXERCISE/DIET</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>MARIANN MOHEB</2></root> 2009-09-21T16:13:16-05:00 2128 115581 2009-09-21T16:13:16-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Suzi Stocker</name><address>800 Route 47, P.O. Box 264</address><city_state_zip>Green Creek, NJ 08219</city_state_zip><phone>6097803670</phone><email>suzanne626@comcast.net</email><emergency_contact>Bruce Schumann</emergency_contact><emergency_phone_>6092318232</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Suzanne M. Stocker</2></root> 2009-09-21T14:34:27-05:00 2128 115411 2009-09-21T14:34:27-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Allison Hellmig</name><address>5 Pine Hollow</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-827-0757</phone><email>Alliemh4128@yahoo.com</email><emergency_contact>Lois Hellmig</emergency_contact><emergency_phone_>609-827-0768</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I would like to sign up for the new session starting 9-28-09. However, I will not be able to attend the first class until that Friday 10-02-09</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Allison Hellmig</2></root> 2009-09-21T08:17:17-05:00 2128 114351 2009-09-21T08:17:17-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Susie</name><address>Owen</address><city_state_zip>West Cape May NJ 08204</city_state_zip><phone>884-2812</phone><email>weallsurf@verizon.net</email><emergency_contact>Mike Owen</emergency_contact><emergency_phone_>609-425-2459</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Susie owen</2></root> 2009-09-20T18:31:40-05:00 2128 114181 2009-09-20T18:31:40-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Becky Gombar</name><address>123 Cedar Lane Easat</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>861-1716</phone><email/><emergency_contact>Al Gombar</emergency_contact><emergency_phone_>861-1716 or 602-3479</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>NO</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>NO</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>NO</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>NO</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>NO</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No chest exercised allowed</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Becky M. Gombar</2></root> 2009-09-18T15:53:01-05:00 2128 113791 2009-09-18T15:53:01-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Marie Floria</name><address>608 Tidewater road</address><city_state_zip>rio grande, nj 08242</city_state_zip><phone>609-889-0857</phone><email>marie.floria@gmail.com</email><emergency_contact>Ron Floria</emergency_contact><emergency_phone_>215-262-7711 </emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>not looking forward to 6:30 but looking forward to trimming down!</please_explain><do_you_have_any_known_cardiovascular_problems>non-sustained VT</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>age...NO</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Marie Floria</2></root> 2009-09-17T17:35:02-05:00 2128 113031 2009-09-17T17:35:02-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jessica Purcell</name><address>30 sunset drive</address><city_state_zip>petersburg, nj 08270</city_state_zip><phone>609-408-4057</phone><email>jjsunny26@hotmail.com</email><emergency_contact>Ed Purcell</emergency_contact><emergency_phone_>609-408-4057</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I did bootcamp in Rio Grande during the summer.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>jp</2></root> 2009-09-17T02:24:45-05:00 2128 112501 2009-09-17T02:24:45-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>ellen furey conger</name><address>91 corson tavern rd</address><city_state_zip>seaville, nj 08230</city_state_zip><phone>609-486-6303</phone><email>furey-conger@comcast.net</email><emergency_contact>chris keever</emergency_contact><emergency_phone_>972-6422</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I have already done the class for 2 months in the spring ,may and june then a few here and there through the summer. Looking foward to a new month of fitness and fun with GI jane!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>yes, on meds</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>blood pressure</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>n</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>ellen furey conger (LYN)</2></root> 2009-09-16T14:27:38-05:00 2128 112361 2009-09-16T14:27:38-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>DAWN CONWAY</name><address>458 DIAS CREEK RD</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-602-0150</phone><email>chickeyface1@yahoo.com</email><emergency_contact>Amanda Iacono</emergency_contact><emergency_phone_>609-602-3672</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I really really need to stay in this program!!!!!</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>sythroid under active thyroid</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>back, neck &amp; knee injury</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Dawn Conway</2></root> 2009-09-16T12:57:44-05:00 2128 112301 2009-09-16T12:57:44-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kelly A. New</name><address>221 E. 1st Avenue</address><city_state_zip>North Wildwood, NJ 08260</city_state_zip><phone>609-522-3045</phone><email>kan1963@hotmail.com</email><emergency_contact>Joe Mahoney</emergency_contact><emergency_phone_>609-425-7199</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>Cervical Surgery 04/07</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kelly A. New</2></root> 2009-09-16T09:59:25-05:00 2128 112101 2009-09-16T09:59:25-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joanne Nagle</name><address>473 Hagan Road</address><city_state_zip>Clermont, NJ 08210</city_state_zip><phone>(609) 425-2880</phone><email>jnagle@1stbankseaisle.com</email><emergency_contact>Rose O&apos;Brien</emergency_contact><emergency_phone_>(609) 425-9248</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Wellbutrin / Zoloft : Depression</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Joanne Nagle</2></root> 2009-09-16T09:57:51-05:00 2128 112091 2009-09-16T09:57:51-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Margie Loveless</name><address>4 Erica Lane</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>(609) 675-8300</phone><email>jnagle@1stbankseaisle.com</email><emergency_contact>Howard Loveless</emergency_contact><emergency_phone_>(609) 226-4782</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>margie Loveless</2></root> 2009-09-16T09:55:50-05:00 2128 112061 2009-09-16T09:55:50-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danielle DiStefano</name><address>458 Corsen Tavern Road</address><city_state_zip>Ocean View, NJ 08230</city_state_zip><phone>(609) 602-9109</phone><email/><emergency_contact>Anthony Fenimore</emergency_contact><emergency_phone_>(609) 408-4170</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Danielle DiStefano</2></root> 2009-09-16T08:09:09-05:00 2128 111991 2009-09-16T08:09:09-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Melanie A. Deegan</name><address>1108 Stone Harbor Blvd.</address><city_state_zip>Stone Harboar, NJ 08247</city_state_zip><phone>609-368-7901 609-425-9159</phone><email>dougdeegan@hotmail.com</email><emergency_contact>Doug Deegan</emergency_contact><emergency_phone_>425-9161 / 368-7901</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Hi Nick, I spoke with you on the phone. I was a regular at your Stone Harbor classes this summer...I could not finish out my ticket because I hurt my back. We talked about me coming to class on Friday the 18th at 9:30 am, using my remaining visits from my summer ticket and then joining the September 28th session. See you this Friday! Melanie Deegan</please_explain><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>I throw my my back out occasionally and I have a problem with my wrist.</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Melanie A. Deegan</2></root> 2009-09-16T07:28:54-05:00 2128 111971 2009-09-16T07:28:54-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Diana Rees</name><address>213 Beechwood Avenue</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-602-7651</phone><email>mermaidangel8@yahoo.com</email><emergency_contact>Bill Staples</emergency_contact><emergency_phone_>609-780-2657</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I&apos;m seeking a place to join and get fit. I really want to be a big loser in body fat that is.</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>levothyroxine for hypo thyroidism</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Diana Rees</2></root> 2009-09-15T13:29:07-05:00 2128 110801 2009-09-15T13:29:07-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Sheila Lauriello</name><address>7501 Ocean Ave</address><city_state_zip>Wildwood Crest, NJ, 08260</city_state_zip><phone>609-523-6722</phone><email>benshe@comcast.net</email><emergency_contact>Ben Lauriello</emergency_contact><emergency_phone_>609-780-1515</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>No</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>Zoloft (pms)</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Sheila F Lauriello</2></root> 2009-09-15T10:51:53-05:00 2128 110431 2009-09-15T10:51:53-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debbie Greene</name><address>25 Mimosa Dr</address><city_state_zip>Rio Grande NJ 08242</city_state_zip><phone>609-408-6800</phone><email>greene_debbie@yahoo.com</email><emergency_contact>Patrick Greene</emergency_contact><emergency_phone_>609-408-6801</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deborah Greene</2></root> 2009-09-14T20:12:33-05:00 2128 109701 2009-09-14T20:12:33-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>maren gandy</name><address>959 myrtle ave</address><city_state_zip>cape may, nj 08204</city_state_zip><phone>6092046514</phone><email>luvmysunflowers@yahoo.com</email><emergency_contact>ike gandy</emergency_contact><emergency_phone_>6098463096</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>n</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>maren r gandy</2></root> 2009-09-14T17:33:58-05:00 2128 109611 2009-09-14T17:33:58-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>lora radzieta</name><address>15 olin dr</address><city_state_zip>cmch, nj, 08210</city_state_zip><phone>609 465 3526</phone><email>loramlove2002@yahoo.com</email><emergency_contact>martin radzieta </emergency_contact><emergency_phone_>4842135120</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain> will be 8 weeks post-pregnancy</please_explain><do_you_have_any_known_cardiovascular_problems>n</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>n</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>n</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>n</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>n</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>n</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>lora radzieta</2></root> 2009-09-14T08:45:06-05:00 2128 107141 2009-09-14T08:45:06-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Pattyann Tangy</name><address>738 Wesley</address><city_state_zip>ocean city NJ 08226</city_state_zip><phone>6092338205</phone><email>pattyanntg@yahoo.com</email><emergency_contact>craig wendt</emergency_contact><emergency_phone_>3340242</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>pattyann tangy</2></root> 2009-09-14T06:07:37-05:00 2128 107021 2009-09-14T06:07:37-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Pam Gentek</name><address>9006 Pacific Ave.</address><city_state_zip>Wildwood Crest, NJ 08260</city_state_zip><phone>609-522-2127</phone><email>dptek@comcast,net</email><emergency_contact>Dean Gentek</emergency_contact><emergency_phone_>609-425-2896</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>No</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>No</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>Yes</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>No</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>No</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>No</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Pam Gentek</2></root> 2009-09-13T08:46:46-05:00 2128 106691 2009-09-13T08:46:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Diane</name><address>Ranalli</address><city_state_zip>9102 Bayview Dr Wildwood Crest, Nj 08260</city_state_zip><phone>-609-729-5805</phone><email>ranalli1968@yahoo.com</email><emergency_contact>Jim Ranalli</emergency_contact><emergency_phone_>7820-0493</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I know that the sessions fill very quickly I would like to sign up for the Oct/Nov session at 9:30 am See you all soon. Diane</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>yes- Thyroid-Synthroid ,Psoriasis-Remicade IV</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Diane Ranalli</2></root> 2009-09-12T05:13:56-05:00 2128 106431 2009-09-12T05:13:56-05:00 <root><i_am_interested_in>Sports Performance</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mukti Prasad Dash</name><address>HiTech Medical College And Hospital</address><city_state_zip>Bhubaneswar, Orissa, India</city_state_zip><phone>09438485423</phone><email>dashmp@yahoo.com</email><emergency_contact>09438485423</emergency_contact><emergency_phone_>09937139250</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>i would like to set up a atheletic performance center please guide me</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>mukti prasad dash</2></root> 2009-09-11T16:43:10-05:00 2128 106261 2009-09-11T16:43:10-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lois Hellmig</name><address>5 Pinehollow</address><city_state_zip>NJ</city_state_zip><phone>609 827-0768</phone><email>lhellmig@aol.com</email><emergency_contact>Gary Hellmig</emergency_contact><emergency_phone_>856-906-9895</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Nick, I spoke with you earlier this morning. I will be there on Monday at 5, for the next two weeks at $60.00 and then full price for the following months. Thanks Lois</please_explain><do_you_have_any_known_cardiovascular_problems>mild hypertension</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>mild hypertension</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>lopressor 25mg for hypertension</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>spinal fusion L5-S1 approx 8 yrs ago, no limitations</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lois Hellmig</2></root> 2009-09-10T17:42:38-05:00 2128 104871 2009-09-10T17:42:38-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Danielle Sharkey</name><address>112 East 7th Avenue</address><city_state_zip>North Wildwood NJ 08260</city_state_zip><phone>(609)729-3829</phone><email>elleinad514@yahoo.com</email><emergency_contact>Ina Sharkey</emergency_contact><emergency_phone_>(609) 602-0257</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Danielle Sharkey</2></root> 2009-09-10T11:08:38-05:00 2128 103761 2009-09-10T11:08:38-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Suzanne Nardi</name><address>722 Dias Creek Road</address><city_state_zip>CMCH., NJ 08210</city_state_zip><phone>609-729-2002</phone><email>soozie1@comcast.net</email><emergency_contact>Karen Patnode</emergency_contact><emergency_phone_>609-827-2892</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I&apos;m back...................................</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>yes</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>birth defects- skull</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Suzanne Nardi</2></root> 2009-09-09T17:28:31-05:00 2128 102481 2009-09-09T17:28:31-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6:00P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lori Schulte</name><address>204 Del Val Rd.</address><city_state_zip>Cape May Court House, NJ</city_state_zip><phone>609 425-8006</phone><email>lorischulte@mac.com</email><emergency_contact>Paul Schulte</emergency_contact><emergency_phone_>609 425-8007</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I&apos;m Back... Since I didn&apos;t see that 5 am class listed, I&apos;d like to come back to my original class. Do you have room for me?</please_explain><do_you_have_any_known_cardiovascular_problems>no</do_you_have_any_known_cardiovascular_problems><do_you_have_diabetes_if_yes_how_long>no</do_you_have_diabetes_if_yes_how_long><has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain>no</has_your_doctor_ever_told_you_that_your_blood_pressure_was_too_high_or_too_low_if_yes_please_explain><are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat>no</are_you_taking_any_medication_if_yes_please_list_the_medication_and_what_they_treat><do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition>no</do_you_have_any_current_or_prior_injuries_or_orthopedic_problems_if_yes_please_list_and_state_current_condition><do_you_have_any_other_medical_conditions_not_previously_mentioned>no</do_you_have_any_other_medical_conditions_not_previously_mentioned><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lori Schulte</2></root> 2009-09-09T09:11:15-05:00 2128 101741 2009-09-09T09:11:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>maren gandy</name><address>959 myrtyle ave</address><city_state_zip>cape may, nj 08204</city_state_zip><phone>609 204 6514</phone><email>luvmysunflowers@yahoo.com</email><emergency_contact>ike gandy</emergency_contact><emergency_phone_>609 846 3096</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>maren r gandy</2></root> 2009-09-08T17:30:59-05:00 2128 101631 2009-09-08T17:30:59-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kimberly Schiela</name><address>2638 Ocean Drive</address><city_state_zip>Avalon, NJ 08202</city_state_zip><phone>609-368-6152</phone><email>kschiela@clermont9.com</email><emergency_contact>Kelly Pfeiffer</emergency_contact><emergency_phone_>609-675-0281</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>kimberly schiela</2></root> 2009-09-05T14:15:24-05:00 2128 101161 2009-09-05T14:15:24-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tina Giaimo</name><address>414 Chatam Drive</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609.602.7634</phone><email>dontina45@hotmail.com</email><emergency_contact>Don Merwin</emergency_contact><emergency_phone_>609.898.0645</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tina Giaimo</2></root> 2009-09-04T14:51:17-05:00 2128 101041 2009-09-04T14:51:17-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Alix Longfellow</name><address>25 Yacht Avenue Apt. 8-B</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-884-3482</phone><email>alixlongfellow@comcast.net</email><emergency_contact>Michael Longfellow</emergency_contact><emergency_phone_>609.425.2251</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Longfellow Alexandra</2></root> 2009-08-31T15:54:00-05:00 2128 99571 2009-08-31T15:54:00-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>susan lemon</name><address>51 easy st.</address><city_state_zip>cmch nj 08210</city_state_zip><phone>6092313788</phone><email>slemon117@comcast.net</email><emergency_contact>george lashley</emergency_contact><emergency_phone_>6094080174</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>susan lemon</2></root> 2009-08-30T12:51:32-05:00 2128 99061 2009-08-30T12:51:32-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Elizabeth churchill</name><address>102 E. florida Ave</address><city_state_zip>villas, NJ 08251</city_state_zip><phone>609-889-1884</phone><email>lizzynan522@comcast.net</email><emergency_contact>karen weinberg </emergency_contact><emergency_phone_>609 8890076</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Elizabeth Churchill</2></root> 2009-08-30T06:16:15-05:00 2128 98951 2009-08-30T06:16:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Brenna Pearce</name><address>6 Buckthorn Lane</address><city_state_zip>Cape May Court House</city_state_zip><phone>6096240065</phone><email/><emergency_contact>ed pearce</emergency_contact><emergency_phone_>6094081422</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Brenna Pearce</2></root> 2009-08-29T18:06:36-05:00 2128 98881 2009-08-29T18:06:36-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>kati delong</name><address>330 w. 16th. ave</address><city_state_zip>wildwood,nj 08260</city_state_zip><phone>609-523-8144</phone><email>delong001@verizon.net</email><emergency_contact>nick delong</emergency_contact><emergency_phone_>609-505-3746</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>kati delong</2></root> 2009-08-29T17:51:25-05:00 2128 98871 2009-08-29T17:51:25-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debbie Greene</name><address>25 Mimosa Dr</address><city_state_zip>Rio Grande NJ 08242</city_state_zip><phone>609-408-6800</phone><email>greene_debbie@yahoo.com</email><emergency_contact>Patrick Greene</emergency_contact><emergency_phone_>609-408-6801</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Please send my the total cost. Thanks, Debbie</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deborah Greene</2></root> 2009-08-29T03:52:30-05:00 2128 98771 2009-08-29T03:52:30-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>karen hunter</name><address>74 north beach avenue</address><city_state_zip>cape may court house, nj 08210</city_state_zip><phone>6094392135</phone><email>kphunter15@gmail.com</email><emergency_contact>jewel romond</emergency_contact><emergency_phone_>6096945323</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>karen hunter</2></root> 2009-08-28T08:16:20-05:00 2128 98441 2009-08-28T08:16:20-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Lauren Otton</name><address>10003 sunrise drive</address><city_state_zip>stone harbor, nj 08247</city_state_zip><phone>609-368-4395</phone><email>lauren@stoneharbor.com</email><emergency_contact>craig otton</emergency_contact><emergency_phone_>609-685-4524</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Lauren Otton</2></root> 2009-08-27T15:11:47-05:00 2128 98301 2009-08-27T15:11:47-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>dawn austin</name><address>1026 ohio avenue</address><city_state_zip>cape may, nj 08204</city_state_zip><phone>609-884-8162</phone><email>dawnaustindesign@yahoo.com</email><emergency_contact>shawn austin</emergency_contact><emergency_phone_>609-884-8162</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Dawn Austin</2></root> 2009-08-26T12:42:25-05:00 2128 97871 2009-08-26T12:42:25-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Betteann Kerr</name><address>476 Hagen Road</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-861-5139</phone><email>rkbk74@comcast.net</email><emergency_contact>Bob Kerr</emergency_contact><emergency_phone_>827-0042</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Betteann Kerr</2></root> 2009-08-25T09:11:09-05:00 2128 97431 2009-08-25T09:11:09-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Patricia Dever</name><address>300 47th Place</address><city_state_zip>Sea Isle City NJ 08243</city_state_zip><phone>609-263-8575</phone><email>devpat@comcast.net</email><emergency_contact>Matt</emergency_contact><emergency_phone_>609-425-0065</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Please let me know if there is a waiting list, and if so how long. Thank you.</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Patricia Dever</2></root> 2009-08-23T17:47:44-05:00 2128 96461 2009-08-23T17:47:44-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>carla</name><address>braca</address><city_state_zip>somers, ny 10598</city_state_zip><phone>914 960 4494</phone><email>BFitNYC@hotmail.com</email><emergency_contact>stephen mcnamara</emergency_contact><emergency_phone_>914 469 6999</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>carla braca</2></root> 2009-08-20T15:31:50-05:00 2128 95441 2009-08-20T15:31:50-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>amber hennessey</name><address>105b angelsea drive</address><city_state_zip>north wildwood</city_state_zip><phone>609-231-8103</phone><email>ambercampbell429@hotmail.com</email><emergency_contact>ambercampbell429@hotmail.com</emergency_contact><emergency_phone_>609-780-0004</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>amber hennessey</2></root> 2009-08-19T12:55:57-05:00 2128 94911 2009-08-19T12:55:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer Franco</name><address>39 Keo Dr Shawcrest</address><city_state_zip>Wildwood, NJ, 08260</city_state_zip><phone>609-675-6063</phone><email>jfranco61288@gmail.com</email><emergency_contact>Thomas Franco</emergency_contact><emergency_phone_>609-729-6572</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jennifer Franco</2></root> 2009-08-19T11:34:38-05:00 2128 94881 2009-08-19T11:34:38-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Rebecca Rich</name><address>PO Box 224</address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>609-412-2005</phone><email>bekkirich@gmail.com</email><emergency_contact>609-425-0201</emergency_contact><emergency_phone_>609-412-2005</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Rebecca Rich</2></root> 2009-08-17T14:57:29-05:00 2128 93831 2009-08-17T14:57:29-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer Buch</name><address>31 Hope Corson Road</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-390-8908</phone><email>scooterjen@msn.com</email><emergency_contact>Scott Buch</emergency_contact><emergency_phone_>609-247-1147</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Loved boot camp, tried three nights in Seaville with Lisa Mason and really want to join! Can&apos;t wait.</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jennifer L. Buch</2></root> 2009-08-17T08:56:00-05:00 2128 93491 2009-08-17T08:56:00-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jean Miersch</name><address>8521 Sunset Drive</address><city_state_zip>Stone Harbor, NJ, 08247</city_state_zip><phone>610-322-8631</phone><email/><emergency_contact>Julie Miersch</emergency_contact><emergency_phone_>610-322-2363</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jean Miersch</2></root> 2009-08-17T08:55:08-05:00 2128 93481 2009-08-17T08:55:08-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Julie Miersch</name><address>8521 Sunset Drive</address><city_state_zip>Stone Harbor, NJ, 08247</city_state_zip><phone>610-322-2363</phone><email/><emergency_contact>Jean Miersch</emergency_contact><emergency_phone_>610-322-8631</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Julie Miersch</2></root> 2009-08-10T11:20:50-05:00 2128 91121 2009-08-10T11:20:50-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Karen Padmore</name><address>1 E Romney Place</address><city_state_zip>Cape May Court House</city_state_zip><phone>609-827-0890</phone><email>karenpadmore@comcast.net</email><emergency_contact>Steve</emergency_contact><emergency_phone_>609-774-0129</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Karen Padmore</2></root> 2009-08-07T19:47:50-05:00 2128 90551 2009-08-07T19:47:50-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Karen Padmore</name><address>1 E Romney Place</address><city_state_zip>Cape May Court House</city_state_zip><phone>609-463-8552</phone><email>karenpadmore@comcast.net</email><emergency_contact>Steve Padmore</emergency_contact><emergency_phone_>609-7740-0129</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Karen Padmore</2></root> 2009-08-06T23:29:09-05:00 2128 90371 2009-08-06T23:29:09-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Desiree Sullivan</name><address>61 stage coach road</address><city_state_zip>cmch NJ 08210</city_state_zip><phone>609-408-9774</phone><email>dfsullivan87@gmail.com</email><emergency_contact>Suzanne Sullivan</emergency_contact><emergency_phone_>609-408-9771</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Desiree Sullivan</2></root> 2009-08-03T14:14:08-05:00 2128 89481 2009-08-03T14:14:08-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kaitlyn Loftus</name><address>262 Franklin Ave</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-780-3901</phone><email>b-ballqueen12@hotmail.com</email><emergency_contact>Sharon Mellor</emergency_contact><emergency_phone_>609-780-5000</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I want to join the only thing is I can&apos;t make it to the class that starts tonight but I was wondering if I could make the class up on Thursday?</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kaitlyn Loftus</2></root> 2009-08-01T11:10:53-05:00 2128 88891 2009-08-01T11:10:53-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>liz brown</name><address>121 east davis avenue</address><city_state_zip>wildwood, nj 08260</city_state_zip><phone>6099724043</phone><email/><emergency_contact>jennifer lanza</emergency_contact><emergency_phone_>6093281865</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>elizabeth brown</2></root> 2009-07-30T18:42:21-05:00 2128 88731 2009-07-30T18:42:21-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debra Leidy</name><address>224 E Florida Ave</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-972-1509</phone><email>njgrl1063d@aol.com</email><emergency_contact>Ruth M. Leidy</emergency_contact><emergency_phone_>609-889-8673</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Debra M Leidy</2></root> 2009-07-29T09:41:36-05:00 2128 88321 2009-07-29T09:41:36-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Ann DeGennaro</name><address>27 Island View Terrace</address><city_state_zip>Seaville, NJ 08230</city_state_zip><phone>609-390-1339</phone><email/><emergency_contact>Paul DeGennaro</emergency_contact><emergency_phone_>609-315-3007</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Ann DeGennaro</2></root> 2009-07-24T15:26:43-05:00 2128 87081 2009-07-24T15:26:43-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Larissa Lelevich</name><address>910 Woolson Road</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-886-0779</phone><email>llelevich@yahoo.com</email><emergency_contact>Jackie Dever</emergency_contact><emergency_phone_>609-972-9725</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Larissa A Lelevich</2></root> 2009-07-22T08:40:45-05:00 2128 86411 2009-07-22T08:40:45-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:15P</for_boot_camp_please_select_the_time_you_are_interested_in><name>CHRISSY GELZUNAS</name><address>102 W 12TH AVENUE</address><city_state_zip>N. WILDWOOD, NJ 08260</city_state_zip><phone>609-827-6775</phone><email/><emergency_contact>RONALD GELZUNAS</emergency_contact><emergency_phone_>609-522-3131</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>CHRISTINE GELZUNAS</2></root> 2009-07-22T08:39:45-05:00 2128 86401 2009-07-22T08:39:45-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:15P</for_boot_camp_please_select_the_time_you_are_interested_in><name>KIMBERLY MASTRIANA</name><address>3813 SHUNPIKE ROAD</address><city_state_zip>RIO GRANDE, NJ 08242</city_state_zip><phone>609-374-2471</phone><email>kmastriana@gmail.com</email><emergency_contact>BILL MASTRIANA</emergency_contact><emergency_phone_>609-374-6717</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>KIMBERLY MASTRIANA</2></root> 2009-07-19T14:23:15-05:00 2128 85571 2009-07-19T14:23:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mary Kinder</name><address>10 West Woodland Ave</address><city_state_zip>CMCH</city_state_zip><phone>609-602-9194</phone><email>mshorern@aol.com</email><emergency_contact>Mike Porch</emergency_contact><emergency_phone_>609-602-2845</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Sorry, forgot to pick the class I wanted with the previous registration. Also, once registered, are you able to attend any of the class times, or do you have to stay with one class. Thx!</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Mary Kinder</2></root> 2009-07-19T14:14:52-05:00 2128 85561 2009-07-19T14:14:52-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mary Kinder</name><address>10 West Woodland Avenue</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-602-9194</phone><email>mshorern@aol.com</email><emergency_contact>Mike Porch</emergency_contact><emergency_phone_>609-602-9191</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Mary Kinder</2></root> 2009-07-17T23:37:07-05:00 2128 85261 2009-07-17T23:37:07-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mimi Wood</name><address>203 Fourth Ave</address><city_state_zip>West Cape May, NJ 08204</city_state_zip><phone>884 1172</phone><email>chefmimi@comcast.net</email><emergency_contact>Chris Wood</emergency_contact><emergency_phone_>374 2844</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Mimi Wood</2></root> 2009-07-15T11:35:57-05:00 2128 84311 2009-07-15T11:35:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:15P</for_boot_camp_please_select_the_time_you_are_interested_in><name>DONNAMARIE BAILEY</name><address>131 HOLLY DRIVE</address><city_state_zip>RIO GRANDE NJ 08242</city_state_zip><phone>6098272732</phone><email>deboshops@yahoo.com</email><emergency_contact>Jim Bailey</emergency_contact><emergency_phone_>6098272732</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>from friend, Kim Tomkinson</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>DonnaMarie Bailey</2></root> 2009-07-12T19:20:43-05:00 2128 83341 2009-07-12T19:20:43-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Sandra Donley</name><address>17 Swainton Goshen Road</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-2554</phone><email>samjon54@comcast.net</email><emergency_contact>John Donley</emergency_contact><emergency_phone_>609-425-3763</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Please let me know how long the waiting list is for Seaville- may be able to go to Rio Grande. Thanks</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Sandra Donley</2></root> 2009-07-09T11:21:08-05:00 2128 82471 2009-07-09T11:21:08-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Carol A Sawyer</name><address>217 Stites Ave.</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>H/609 465-9774 cell/602-2751 </phone><email>cas_sawyer@yahoo.com</email><emergency_contact>Steve Krueger</emergency_contact><emergency_phone_>609 972-4371</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Nick, I am a friend of Jennifer Armstrong from The Chamber Board, who is in this class and would like to start with her today, if possible 7/9/09. I also am a new member of the Middle Township Chamber and I at at the same table with Jennifer in June. Thank you and please let me know if it is OK to start with Jen tonight. Sorry for the last minute sign up, but Jen just mentioned it to me and personally I have really allowed myself to get out of shape in the last 4 yrs. Carol</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Carol A. Sawyer</2></root> 2009-07-05T09:34:57-05:00 2128 80291 2009-07-05T09:34:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>Deb Paine</name><address>2520 Donlenik Dr</address><city_state_zip>York PA 17402</city_state_zip><phone>7178177383</phone><email>dlpaine@comcast.net</email><emergency_contact>Jim</emergency_contact><emergency_phone_>71781718888</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>sign on 96th street had boot camp info. We are only here for a week can we take the class on Mon Wed and Fri/</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Deb Paine</2></root> 2009-07-01T08:02:51-05:00 2128 79211 2009-07-01T08:02:51-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Megan Donohue</name><address>22 Freedom Dr</address><city_state_zip>Cape May,NJ 08204</city_state_zip><phone>609-898-9659</phone><email/><emergency_contact>Ed Donohue</emergency_contact><emergency_phone_>609-780-4768</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am currently in the June class.</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Megan Donohue</2></root> 2009-06-25T04:37:33-05:00 2128 76981 2009-06-25T04:37:33-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 5:15P</for_boot_camp_please_select_the_time_you_are_interested_in><name>TARA HINES</name><address>209 W Shell Bay Ave</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-463-8215</phone><email>tarahines@comcast.net</email><emergency_contact>Francis Hines</emergency_contact><emergency_phone_>609-602-0974</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Tara E Hines</2></root> 2009-06-24T21:53:41-05:00 2128 76921 2009-06-24T21:53:41-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>anita matousch</name><address>1 nadine blvd</address><city_state_zip>ocean view,nj 08230</city_state_zip><phone>609-390-2826</phone><email>nic93rach95@msn.com</email><emergency_contact>don matousch</emergency_contact><emergency_phone_>609-390-2826</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am currently in the Seaville evening class and I&apos;m enjoying it very much ,so I would like to sign up for the July session. Thanks so much anita</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>anita matousch</2></root> 2009-06-23T08:42:41-05:00 2128 76001 2009-06-23T08:42:41-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kimberly Tomkinson</name><address>PO Box 934</address><city_state_zip>CMCH NJ 08210</city_state_zip><phone>609-780-3608</phone><email>kimtomkinson@comcast.net</email><emergency_contact>D. Tomkinson</emergency_contact><emergency_phone_>609-485-6756</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Hey Nick, Can you sign me up once again for the Tues Thurs 6-7 boot camp. Also, I was gonna stop in today and ask you but I was going to renew my membership with the gym today since boot camp doesnt start until July 6. How will that effect signing up for boot camp since that includes your gym membership? Talk to you soon!! Kim</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Kimberly Tomkinson</2></root> 2009-06-22T11:45:52-05:00 2128 75431 2009-06-22T11:45:52-05:00 <root><i_am_interested_in>Nutrition</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>Margie Green</name><address>1002 Millman Blvd.</address><city_state_zip>Del Haven, NJ 08251</city_state_zip><phone>609-886-0755</phone><email>margienjohn@comcast.net</email><emergency_contact>John Green</emergency_contact><emergency_phone_>609-886-0755</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Margie Green</2></root> 2009-06-21T18:42:24-05:00 2128 75091 2009-06-21T18:42:24-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Outdoor Boot Camp</for_boot_camp_please_select_the_time_you_are_interested_in><name>Alice Meehan</name><address>714 Fox Hollow Road</address><city_state_zip>Lower Gwynedd, PA 19002</city_state_zip><phone>215-651-0402</phone><email>alicemeehan@jdm-inc.com</email><emergency_contact>Carsy Missett</emergency_contact><emergency_phone_>610-764-7273</emergency_phone_><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Alice Meehan</2></root> 2009-06-17T17:11:11-05:00 2128 73601 2009-06-17T17:11:11-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Becka Arenberg</name><address>270 104th St. </address><city_state_zip>Stone Harbor, NJ 08247</city_state_zip><phone>609-425-7421</phone><email>becks19@aol.com</email><emergency_contact>Noel Haldeman</emergency_contact><emergency_phone_>215-407-4026</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Rebecca Arenberg</2></root> 2009-06-17T14:37:57-05:00 2128 73531 2009-06-17T14:37:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jenifer Wyers</name><address>734 Stagecoach Road</address><city_state_zip>Marmora, NJ 08223</city_state_zip><phone>6093901614</phone><email>sprint84@comcast.net</email><emergency_contact>Pat Mason</emergency_contact><emergency_phone_>6096282000</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain/><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jenifer Wyers</2></root> 2009-06-16T05:34:32-05:00 2128 72891 2009-06-16T05:34:32-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer C. Armstrong</name><address>610 Cedar Ave</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-231-8106</phone><email>chuckjen@comcast.net</email><emergency_contact>Chuck Armstrong</emergency_contact><emergency_phone_>609-231-6986</emergency_phone_><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>Nick, It&apos;s Jen I&apos;m only able to do this this week and next because I go on vacation from June 29th thru July 6 and will then start back on July 7th. Please call me and let me know how much so I can bring it tonight. Thanks. Jen</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Jennifer C. Armstrong</2></root> 2009-06-15T21:30:04-05:00 2128 72841 2009-06-15T21:30:04-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>lisa mason</name><address>166 rt. 50</address><city_state_zip>seaville, nj 08230</city_state_zip><phone>609-374-4683</phone><email>monalis533@comcast.net</email><emergency_contact>david mason</emergency_contact><emergency_phone_>374-4684</emergency_phone_><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>would like to start next session in seaville, night class time. could you please let me know when it starts again. thanks lisa mason</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>lisa mason</2></root> 2009-06-13T07:04:32-05:00 2128 72041 2009-06-13T07:04:32-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Theresa Casey</name><address>402 Route 9 North</address><city_state_zip>Cape May Ct Hs, NJ 08210</city_state_zip><phone>609-463-4669</phone><email>caseytmc@comcast.net</email><emergency_contact>Allen Davis</emergency_contact><emergency_phone_>609-847-0409</emergency_phone_><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Hi Nick, We talked about this at Thursdays Chamber lunch. I&apos;ll see you Tuesday night. Let me know if you need anything else. Theresa Casey</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>Theresa M Casey</2></root> 2009-06-08T14:01:39-05:00 2128 70121 2009-06-08T14:01:39-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Barbara Zuzulock</name><address>308 w. wildwood ave</address><city_state_zip>wildwood NJ 08260</city_state_zip><phone>6097291322</phone><email>bzuz308@verizon.net</email><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>My sister in law Melissa Zuzulock</please_explain><informed_consent_release_>By checking this box I agree that I have read the foregoing carefully and agree to all its content. By putting my name below in the signature box I agree that this online signature takes place of and represents my actual signing.</informed_consent_release_><2>barbara zuzulock</2></root> 2009-06-04T18:59:21-05:00 2128 69201 2009-06-04T18:59:21-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Paula Smith</name><address>PO Box 441</address><city_state_zip>South Seaville, NJ 08246</city_state_zip><phone>609-231-9117</phone><email>s.paula63@yahoo.com</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Hi, I paid $119.00 in Seaville tonight. They thought that you had a 6P mwf in Rio. I am not seeing that. Tue/Thurs will be fine. Please let me know if I have to do anything else. Thanks Paula</please_explain><informed_consent_release_>This box represents my signature in agreeing that I have read the foregoing carefully and agree to all its content.</informed_consent_release_></root> 2009-06-01T16:45:46-05:00 2128 67931 2009-06-01T16:45:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Debra Renza</name><address>3 Holly Knoll Drive</address><city_state_zip>Swainton, NJ 08210</city_state_zip><phone>609-463-9644</phone><email>Debrenza@aol.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>The MWF class is the only one I could attend right now. I know it is sold out, but if a spot opens up, please call me.</please_explain></root> 2009-06-01T08:19:18-05:00 2128 67521 2009-06-01T08:19:18-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Donna J Mason</name><address>421 Old Tuckahoe Road</address><city_state_zip>Petersburg, NJ 08270</city_state_zip><phone>609-628-3082</phone><email>dmason@ochome.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Would like to sign up for the Seaville Camp. I faxed paper work months ago but there was not an opening for Seaville.</please_explain></root> 2009-06-01T07:59:19-05:00 2128 67511 2009-06-01T07:59:19-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jessica Purcell</name><address>30 Sunset Drive</address><city_state_zip>Petersburg, NJ 08270</city_state_zip><phone>609 408 4057</phone><email>jjsunny26@hotmail.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-06-01T07:54:46-05:00 2128 67501 2009-06-01T07:54:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joanne Nagle</name><address>473 Hagan Road</address><city_state_zip>Clermont, NJ 08210</city_state_zip><phone>609 861 2902</phone><email>jnagle@1stbankseaisle.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am not able to make the orientation. I have to work. My girlfriend is signing up with me also, so she is going to go to the meeting and fill me in. Is that okay?</please_explain></root> 2009-05-31T08:36:45-05:00 2128 67281 2009-05-31T08:36:45-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Elizabeth Klausner</name><address>22 E Wilde Avenue</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609-560-2609</phone><email>elizabethswish@aol.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-28T16:37:37-05:00 2128 66781 2009-05-28T16:37:37-05:00 <root><i_am_interested_in>Sports Performance</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>jacqueline pedroni-smith</name><address>9 jacqueline ct </address><city_state_zip>clermont n.j. 08210</city_state_zip><phone>609-624-3788</phone><email>jacqueps@comcast.net</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>Nick, I was looking for a rate to have the whole family join but in different services you offer. My two boys in sports and my daughter and I in boot camp or membership. Please call me with any kind of package you can think of . Thank you Jacque Pedroni-Smith </please_explain></root> 2009-05-28T16:31:39-05:00 2128 66771 2009-05-28T16:31:39-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>jacqueline pedroni-smith</name><address>9 jacqueline ct</address><city_state_zip>clermont n.j. 08210</city_state_zip><phone>609-624-3788</phone><email>jacqueps@comcast.net</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-28T11:11:27-05:00 2128 66661 2009-05-28T11:11:27-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Brenda L. Pfaff</name><address>229 Suzanne Ave</address><city_state_zip>N. Cape May</city_state_zip><phone>609-889-1214</phone><email>brendapfaff@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-27T13:15:46-05:00 2128 66371 2009-05-27T13:15:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Kaitlyn OConnor</name><address>808 Heather Ln</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-408-6328</phone><email>doconnor@atlantic.edu</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-27T13:14:24-05:00 2128 66361 2009-05-27T13:14:24-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Denise OConnor</name><address>808 Heather Ln</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-231-5641</phone><email>doconnor@atlantic.edu</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-22T12:27:05-05:00 2128 65501 2009-05-22T12:27:05-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Allison Rothenbiller</name><address>43 crest rd </address><city_state_zip>cmch nj 08210</city_state_zip><phone>609 408 9558</phone><email>rothenbillera@middletwp.k12.nj.us</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I am currenly enrolled in the may session (mon 4-5 class, tues/thurs 6-7 class). I&apos;d like to enroll for the June session MWF 9:30 class but school does not finish until the 17th. Can I just continue take the classes I am currely enrolled in now and then attend the morning class when school is out? Let me know if this is possible. Thanks!</please_explain></root> 2009-05-21T19:18:12-05:00 2128 65411 2009-05-21T19:18:12-05:00 <root><i_am_interested_in>Personal Training</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Allyson Japzon</name><address>15 Somers Ave</address><city_state_zip>Seaville NJ 08230</city_state_zip><phone>624-1325</phone><email>ajapzon@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I am in my third session of boot camp in Seaville, and I will not be able to sign up for the June session due to babysitting issues. Therefore, I was looking for information for a personal trainer.</please_explain></root> 2009-05-21T10:40:35-05:00 2128 65131 2009-05-21T10:40:35-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Fabianna Hacket </name><address> park ave</address><city_state_zip>marmora nj 08223</city_state_zip><phone>609 390-2048</phone><email/><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I have thyroid issues and have been struggling with my weight a long time. This class sounds like just the thing to get me feeling and looking great!</please_explain></root> 2009-05-21T10:36:15-05:00 2128 65121 2009-05-21T10:36:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jessica Caine</name><address>429 central ave </address><city_state_zip>ocean city nj</city_state_zip><phone>609 780-3854</phone><email/><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Ive struggled with being over weight most my life. I in the past year have lost over 60lbs doing weight watchers. I now feel i have hit a wall and need serious motivation to continue getting in shape. I hear this class is what i need!</please_explain></root> 2009-05-21T10:32:18-05:00 2128 65111 2009-05-21T10:32:18-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Katrina Caine</name><address>210 woodland ave</address><city_state_zip>marmora nj 08223</city_state_zip><phone>390-1906 cell 374-2320</phone><email>tj-katrina@comcast.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I am a 31 yr old mother of 3. I eat sleep breath my kids. I havent done much for me in awhile. After my 3rd child 10 months ago i now see i really need to start doing for me. I no longer recognize the person in the mirror. I need some serious motivation to get myself into shape. I am praying this class is my answer! ps i have a few friends that are joining also, they too need some motivation!!</please_explain></root> 2009-05-20T18:54:11-05:00 2128 64971 2009-05-20T18:54:11-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Ellen Schuster</name><address>113 Timothy Lane</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-7571</phone><email>eeschuster@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I&apos;d l ike to sign up for the next session on June 8. I&apos;m interested in the T/TH at 7:00</please_explain></root> 2009-05-15T06:43:15-05:00 2128 63551 2009-05-15T06:43:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Carol Sieber</name><address>5 Faith Run</address><city_state_zip>Swainton NJ 08210</city_state_zip><phone>609-463-0836</phone><email>casieber@comcast.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I have friends here at work who are raving about the Boot Camp! Can&apos;t wait to join! Can I start this Tuesday or should I wait til the new session begins?</please_explain></root> 2009-05-13T10:32:58-05:00 2128 62671 2009-05-13T10:32:58-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jillian Tilsner</name><address>930 Main Street</address><city_state_zip>Cape May, NJ 08204</city_state_zip><phone>609-889-8819</phone><email>jilliantilsner@hotmail.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-12T09:35:35-05:00 2128 62471 2009-05-12T09:35:35-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Anne Dagney</name><address>11 E Florida Ave</address><city_state_zip>Villas, NJ 08251</city_state_zip><phone>609 886 3388</phone><email>annied7@comcast.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-12T02:45:22-05:00 2128 62411 2009-05-12T02:45:22-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer Anzelone</name><address>3506 Hudson Avenue</address><city_state_zip>Wildwood NJ 08260</city_state_zip><phone>609-602-7289</phone><email>jenniferanzelone@yahoo.com</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I would like to join the june 8th boot camp in Rio Grande, mon, wed, fri from 4pm to 5pm</please_explain></root> 2009-05-12T02:42:45-05:00 2128 62401 2009-05-12T02:42:45-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jennifer Anzelone</name><address>3506 Hudson Avenue</address><city_state_zip>Wildwood, NJ 08260</city_state_zip><phone>609-602-7289</phone><email>jenniferanzelone@yahoo.com</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain>I would like to join the May 11th bootcamp in Rio Grande on mon,wed,fri from 10:30-11:30 if it&apos;s still open. Also I work shift work, if I have to miss due to shift change can I attend a different time class that day?</please_explain></root> 2009-05-07T12:46:59-05:00 2128 61021 2009-05-07T12:46:59-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>michele keith</name><address>100 n ravenwood dr</address><city_state_zip>clermont, nj 08210</city_state_zip><phone>609-602-3895</phone><email>phillies123@msn.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-07T03:20:11-05:00 2128 60771 2009-05-07T03:20:11-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Rachelle Carbonaro</name><address>225 East Spicer Ave</address><city_state_zip>Wildwood, NJ 08260</city_state_zip><phone>609-605-3505</phone><email>rachelle.carbonaro@gmail.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Very interesting is starting as soon as possible..just need to know how and when to sign up for the next class. Thanks, Rachelle</please_explain></root> 2009-05-06T19:56:01-05:00 2128 60711 2009-05-06T19:56:01-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Vicki A Walton</name><address>6 Woodview Lane</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-463-3789</phone><email>vawalton22@verizon.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-05T22:32:15-05:00 2128 60541 2009-05-05T22:32:15-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>ellen furey -conger</name><address>91 corson tavern rd</address><city_state_zip>seaville nj 08230</city_state_zip><phone>6094636303</phone><email>furey-conger@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>I would like to start this bootcamp on Monday the 11th in seaville. I used to take kisk boxing classes with Nick in rio grande with my son 4 years ago and I loved it. I recently lost some wieght and have been walking all winter so I think I am ready. I am no longer a member . Can I sign up to get in by monday the 11th?</please_explain></root> 2009-05-05T16:59:29-05:00 2128 60481 2009-05-05T16:59:29-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Bonnie Berkey</name><address>PO Box 423</address><city_state_zip>NJ</city_state_zip><phone>6092140513</phone><email>bosco1209@yahoo.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-04T16:44:11-05:00 2128 60111 2009-05-04T16:44:11-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tracey Fetsick</name><address>605 Atlantic Avenue - 2nd floor</address><city_state_zip>North Wildwood, NJ 08260</city_state_zip><phone>D 884-9975 / E 523-6573</phone><email>tlfetsick@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>Class availabilitiy</please_explain></root> 2009-05-04T14:51:06-05:00 2128 59961 2009-05-04T14:51:06-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>sharon ashbridge</name><address>202 w vineyard court</address><city_state_zip>cape may nj 08204</city_state_zip><phone>609-425-2329</phone><email>sashbridge@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-04T00:33:46-05:00 2128 59431 2009-05-04T00:33:46-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Justine Foster</name><address>125 East Buttercup Rd.</address><city_state_zip>Wildwood Crest</city_state_zip><phone>609-334-0112</phone><email>JJFost@gmail.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-03T20:03:21-05:00 2128 59171 2009-05-03T20:03:21-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>angela anes</name><address>621 Pleasure Ave</address><city_state_zip>ocean cit, nj 08226</city_state_zip><phone>609425-2518</phone><email>sunybeach42@COMCAST.NET</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-03T18:58:14-05:00 2128 59161 2009-05-03T18:58:14-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 4P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Suzanne Nardi</name><address>722 Dias Creek Road</address><city_state_zip>C.M.C.H., NJ 08210</city_state_zip><phone>609-675-4228</phone><email>soozie1@comcast.net</email><how_did_hear_about_pac>Other</how_did_hear_about_pac><please_explain>I&apos;m back. I am pretty sure Karen signed me up. Will you have the 5:30-6:00pm class in June and July? I will switch to that class for the summer. I spoke with your Mom the other day. We have a really cute exercise duck for this year. I am so excited about the meals to go. That is the hardest part for me. Junk food. See you tomorrow Suzanne</please_explain></root> 2009-05-03T11:02:56-05:00 2128 58991 2009-05-03T11:02:56-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Mary Ciccarone</name><address>203 Court House S. Dennis Rd</address><city_state_zip>CMCH</city_state_zip><phone>609-231-9654</phone><email>mary_ciccarone@hotmail.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-02T12:36:39-05:00 2128 58771 2009-05-02T12:36:39-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jeanann Lloyd</name><address>316 Raleigh Avenue</address><city_state_zip>Cape May Court House, NJ 08210</city_state_zip><phone>609-465-1653</phone><email>jalloyd828@verizon.ner</email><how_did_hear_about_pac>Radio Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-02T11:59:02-05:00 2128 58761 2009-05-02T11:59:02-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Juli Musser</name><address>3 Newport Drive</address><city_state_zip>NJ</city_state_zip><phone>609 846-3137</phone><email>juli.musser@gmail.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-05-01T11:14:00-05:00 2128 58521 2009-05-01T11:14:00-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Carol Lynch</name><address>161 Woodbine Road</address><city_state_zip>Steelmantown, NJ 08270</city_state_zip><phone>609-374-4688</phone><email>carol-ets@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-30T20:04:40-05:00 2128 58371 2009-04-30T20:04:40-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>paula vandergrift</name><address>210 Pennsyvania Ave </address><city_state_zip>villas, nj 08251</city_state_zip><phone>8562783993</phone><email>paula4863@verizon.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-30T20:03:06-05:00 2128 58361 2009-04-30T20:03:06-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>paula vandergrift</name><address>210 Pennsyvania Ave </address><city_state_zip>villas, nj 08251</city_state_zip><phone>8562783993</phone><email>paula4863@verizon.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-30T19:07:51-05:00 2128 58341 2009-04-30T19:07:51-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Angela Rader</name><address>402 George st.</address><city_state_zip>erma, Nj</city_state_zip><phone>6098983888</phone><email>dancerr0814@aim.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-30T15:18:57-05:00 2128 58231 2009-04-30T15:18:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Patti Dawson</name><address>3 Camlough Road</address><city_state_zip>Petersburg, nj 08270</city_state_zip><phone>602-3153</phone><email>patti1110@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>When does the session after May 11th begin?</please_explain></root> 2009-04-29T20:36:55-05:00 2128 58021 2009-04-29T20:36:55-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Joanie Keating</name><address>9 Avalonwoods Court</address><city_state_zip>Swainton,N.J. 08210</city_state_zip><phone>609-675-1562</phone><email>jmkeating8@hotmail.com</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-29T15:39:39-05:00 2128 57841 2009-04-29T15:39:39-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Tracey Fetsick</name><address>605 Atlantic Avenue, 2nd floor</address><city_state_zip>North Wildwood, NJ 08260</city_state_zip><phone>609-523-6573</phone><email>tlfetsick@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-29T11:52:57-05:00 2128 57801 2009-04-29T11:52:57-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>MARINA HEWETT</name><address>45 INDIAN TRAIL RD</address><city_state_zip>CAPE MAY COURT HOUSE</city_state_zip><phone>609-827-4590</phone><email>marinahewett@ymail.com</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain>can I apply the free trial 7 day coupon toward the cost of the one month boot camp? I have two friends that I am planning on convincing to join with me. Please get back to me asap so I can work out a child care schedule.</please_explain></root> 2009-04-29T07:05:14-05:00 2128 57681 2009-04-29T07:05:14-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 10:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>carole goss</name><address>747 tabernacle road</address><city_state_zip>cold spring nj 08204</city_state_zip><phone>609-884-4737</phone><email>carolegoss@comcast.net</email><how_did_hear_about_pac>Newspaper Ad</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-27T13:42:16-05:00 2128 57536 2009-04-27T13:42:16-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>darleen devlin</name><address>7804 seaview avenue</address><city_state_zip>wildwood crest, nj 08260</city_state_zip><phone>609-233-3372</phone><email>ddevlin@wildwoodcrest.org or thedevlins04@verizon.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hi Nick, I&apos;m looking to join the Tuesday/Thursday session at 6PM. Please call me with any questions!!!!! I&apos;m looking forward to the first nhight!!!!!!</please_explain></root> 2009-04-24T14:08:34-05:00 2128 57463 2009-04-24T14:08:34-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 6P</for_boot_camp_please_select_the_time_you_are_interested_in><name>darleen devlin</name><address>7804 seaview avenue</address><city_state_zip>wildwood crest, nj 08260</city_state_zip><phone>609-233-3372</phone><email>thedevlins04@verizon.net or ddevlin@wildwoodcrest.org</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>I&apos;d love to join your Tues/Thurd 6-7 boot camp. My parents, Matt and Janice Tomlin are members of the gym and I ould like to see the boot camp program thanks to Trish Feketics!!!!! Let me know the availalbility and the price! I look forward to working out with you!!!!!!</please_explain></root> 2009-04-24T11:34:40-05:00 2128 57456 2009-04-24T11:34:40-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Amy Souder</name><address>743 Sunset Blvd.</address><city_state_zip>West Cape May, NJ 08204</city_state_zip><phone>609-827-5969</phone><email>soudera@lcmrschools.com</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-21T20:22:09-05:00 2128 57386 2009-04-21T20:22:09-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Sea MW 7:30P/F 6:30P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Jamie Lynn Sullivan</name><address>168 Chestnut St</address><city_state_zip>Belleplain, NJ 08270</city_state_zip><phone>609-221-1769</phone><email>jamee.sullivan@gmail.com</email><how_did_hear_about_pac>Miracles Fitness</how_did_hear_about_pac><please_explain></please_explain></root> 2009-04-21T09:45:19-05:00 2128 57374 2009-04-21T09:45:19-05:00 <root><i_am_interested_in>Boot Camp</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio T/Th 7P</for_boot_camp_please_select_the_time_you_are_interested_in><name>Dawn Oliver</name><address>619 Route 9 North</address><city_state_zip>CMCH, NJ 08210</city_state_zip><phone>609-463-0718</phone><email>olivergirlz@verizon.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Would like to sign up for May 11th session. Is there a class I could watch before then just to make sure this is something I can/want to do?</please_explain></root> 2009-04-19T16:21:43-05:00 2128 57335 2009-04-19T16:21:43-05:00 <root><i_am_interested_in>Personal Training</i_am_interested_in><for_boot_camp_please_select_the_time_you_are_interested_in>Rio MWF 9:30A</for_boot_camp_please_select_the_time_you_are_interested_in><name>Suzi Stocker</name><address>800 Route 47, P.O. Box 359</address><city_state_zip>Green Creek, NJ 08219</city_state_zip><phone>609-780-3670</phone><email>suzanne626@comcast.net</email><how_did_hear_about_pac>Word of Mouth</how_did_hear_about_pac><please_explain>Hey Nick, I talked to you on Friday afternoon at bootcamp about getting a personal trainer. I&apos;d like to do something first thing in the morning on Tuesday and Thu