Physical Registration Form - Myers Fitness Centre

Full Name *

First

Last

Gender *

Email *

D.O.B *

Email Address

Residential Address

Residential address should include the following: Parish, City, Street Zip code NA

Telephone Number *

Job Title | Place of Work *

Emergency Contact *

First

Last

Emergency Phone Number

Have you done any workout programs before?

When was the last time you have participated in physical fitness programs?

1 Month Ago
2 Months Ago
Never

What are your goals?

What do you hope to achieve by joining the gym?

Medical Information

Are there any illnesses, medical or physical condition or have you ever done surgery that may have a negative impact while exercising?(Please specify below).Please provide the details and frequency of dosages. Enter N/A if none (Please answer truthfully as failure to provide truthful information in regards to your medical history that could be made worst by working out could result in severe injuries. Be cautious, clients workout at their own risk, Myers Fitness Centre will not be held accountable for any injuries that may be sustained while using the facility).

By checking this field and submitting this form, I conform to the terms and conditions hereunder

I UNDERSTAND AND HAVE ACCEPTED THESE TERMS AGREEMENTS AND RESPONSIBILITIES.

All fees are non-refundable and non-transferable to another person. THERE WILL BE NO ROLL OVER IF YOU SIGN UP AND WERE NOT ABLE TO START. Membership payment entitles you to all gym services except personal training, spin and yoga, boxing etc. Your monthly payments are scheduled to renew on the date you start the gym. Members will not be allowed to attend the gym after expiry date. First time clients must see an Instructor before using any equipment. If your fail to obey, we will not be responsible for any damages caused to you. We are not responsible for any liabilities and injuries which may occur when one uses the gym without supervision or when one does not obey gym rules. Work out at your own risk. Make sure to check with your doctor before starting this fitness program. I, the undersigned having accepted membership, have read, understood, agree and accept the above terms and regulations of the gym.