Motion Fitness Corporate

Name*

First NameLast Name
Are you an employee, or an employee's family member?

EmployeeFamily-Member
Employee's Name:

First NameLast Name
Company Name:*
Birthdate
Date of Birth*

MonthDayYear
If under 18, please bring guardian on first visit.
Gender
Address*

Street Address

CityProvince

Postal Code
Phone Number*

Area CodePhone Number
Email*
example@example.com
Location*
Select a payment plan:*
You can add up to three family members to this offer.
Would you like to add a family member?

YesNo
How many would you like to add?
In addition to yourself.
Family Member 1
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Family Member 1's Email
example@example.com
Family Member 2
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Family Member 2's Email
example@example.com
Family Member 3
Name

First NameLast Name
Date of Birth

MonthDayYear
Date
Gender
Family Member 3's Email
example@example.com
Total
This price reflects the cost of the plan you chose (either bi-weekly or annual), multiplied by the amount of family members you are adding, + 5% tax.

Your Total:*

CAD

Do you agree to the below Terms & Conditions?*

I agree
Please bring your banking information to your first visit.

*Please note that you are signing up for a 1-year term.
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