Welcome To The Fitness Firm - Online Member Sign Up

Selected Home Club: Front door [Club Details]


6 Week Spring Challenge
6 Week Spring Challenge

Membership Includes:
12 Personal Training Sessions
Meal Plan
24 hr gym access for the 6 weeks
30 min goal setting session


Additional Information:
All participants start week of April 15
Up to 12 participants
Cash Prize for winner with most Fat Loss



MEMBERSHIP BREAKDOWN
Initial Payment
Membership
$699.00
Taxes
$90.87
Amount due now:
$789.87

MEMBER INFORMATION
 
Please complete all of the following fields. You only need to enter 1 telephone contact; when entering a telephone number please enter all 10 digits without any spaces; when entering the postal code please enter all 6 characters without any spaces.
 
First Name   Last Name   Gender   Date of Birth
    Male Female  
 
Street Address   Province/State   City   Postal/ZIP   Email (Username)
       
 
Home Tel.   Mobile   Emergency Contact   Emergency Tel.   Referral Source
       
 

INITIAL PAYMENT INFORMATION
 
Card Type   Card Number  
   
 
Expiry Date   Cardholder Name   CSV [?]
   
 
Use address above for billing information
 
Street Address   Province/State
 
 
City   Postal/ZIP
 
 

OTHER MEMBERSHIP TERMS
 
Before finalizing your purchase, please carefully read the following terms and conditions.
 
New members only OR
New personal training clients
Paid in full
 
Electronic Signature

I understand that my electronic signature below constitutes a legal signature confirming acceptance of the membership agreement.


Please sign below