First Name:
Last Name:
Date of Birth:
Gender:
Street Address:
City:
State/Province:
Postal/Zip Code:
Phone Number:
Email Address:
Emergency Contact Name:
Emergency Contact Phone Number:
Emergency Contact Relationship:
Membership Type:
Desired Start Date:
Preferred Contact Method:
Thank you for your interest! A membership consultant will contact you shortly to discuss payment options and complete your registration.
Have you exercised regularly in the past?
Do you have any current health conditions or injuries we should be aware of?
Are you currently taking any medications?
Have you ever experienced any chest pain, dizziness, or shortness of breath during exercise?
Do you have any dietary restrictions or preferences?
What are your fitness goals? (e.g., Weight loss, Muscle gain, General fitness, Specific sport training)
What are your preferred workout activities? (e.g., Cardio, Strength training, Group classes, Swimming)
Have you read and understood the gym's terms and conditions?
Do you agree to the gym's waiver of liability?
Do you consent to the gym using your image or likeness in promotional materials?
Please sign here:
How did you hear about us?
Social media
Referral
Advertisement
Website
Preferred time to work out:
Morning
Afternoon
Evening
Interests:
Form Template Instructions
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Important Considerations
Instructions for I. Personal Information
Instructions for II. Membership Details
Instructions for V. Optional Information