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Registration

Please find below our membership registration form. The questions are so we can be informed of any health issues prior to you signing up.

You can either submit this form electronically or feel free to print it out and bring it with you for your consultation.



Date of Birth (DD/MM/YY)





Gender:

How do you hear about us?

Emergency Contact Details



Physical Activity Readiness Questionnaire
(Please tick yes or no)

Please speak to instructor if you answer YES to any of these questions

Have you, for any reason, been unable to exercise in the past?
YesNo

Has your physician/doctor ever advised you against exercising?
YesNo

Have you ever suffered from any cardiac heart‑ related illness?
YesNo

Have you ever suffered from respiratory difficulties?
YesNo

Have you ever suffered from fainting, migraines or loss of balance?
YesNo

Have you ever suffered from any bone, joint or muscle related disease?
YesNo

Is there any history of heart disease in your family?
YesNo

Have you experienced chest pain whilst exercising?
YesNo

Do you have high blood pressure?
YesNo

Do you have elevated cholesterol levels?
YesNo

Are you currently taking prescribed medication?
YesNo

Important

If you answered yes to any of the questions above (PARQ),Please give details below. All information provided is held in the strictest confidence and accessible only by the Gym manager and relevant staff

Declaration

I have read and understood the terms and conditions (which can be found in the footer of the website) of the fitness junction and agree to abide by them. I am fit and healthy and able to use the gym on a regular basis. I understand that my membership can be revoked at any time should I fail to comply with these terms and conditions. I have declared myself medically able to use the gym and take part in classes and understand that I do so at my own risk. this does not affect my rights as a consumer for any accident caused by negligence of the fitness junction.

The person making this application is under 18 will have to come in the gym with an appropriate adult.

Please tick this box to accept the declaration

Our terms and conditions can be found here.  If you have any questions please call us:

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