Returning Client Registration & Payment Only Order Form
Fill out the form carefully for registration
Student Name
First Name
Middle Name
Last Name
Student E-mail
example@example.com
Mobile Number
Please indicate the class(es) you are registering for
Fitness Mondays 9:00a.m. - 10:00a.m. @ ONLINE from the comfort of your home
Block Therapy Mondays 12:00p.m. – 1:00p.m. @ ONLINE from the comfort of your home
Block Therapy Mondays 4:00p.m. – 5:00p.m. @ Central Plains RecPlex in Southport
Fitness Mondays 6:00p.m. - 7:00p.m. @ 23159 Road 60 North
Block Therapy Tuesdays 4:00p.m. – 5:00p.m. @ 23159 Road 60 North
Block Therapy Wednesdays 5:00p.m. – 6:00p.m. @ Just Be Wellness Studio in Portage La Prairie
Fitness Wednesdays 7:00p.m. - 8:00p.m. @ 425-5th Ave in Oakville
Fitness Fridays 10:00a.m. - 11:00a.m. @ 23159 Road 60 North
Block Therapy Fridays 12:00p.m. - 1:00p.m. @ 425-5th Ave in Oakville
Buying a Product below
Please indicate the Date you would like your pass to begin and/or any additional details (You can register for multiple classes at once) *Class Punch Passes for Southport RecPlex will be provided at the front desk; other locations will be tracked by Jen*
My Products
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Block Buddy New
Used more frequently - for those >5ft
$
134.34
CAD
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0.00
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Block Baby New
Smaller version of Block Buddy - for those <5ft or with smaller structures
$
134.34
CAD
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0.00
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Block Buddy Student Rental
Rent a Student Block Buddy at a daily Rate to take home and use between classes, please choose quantity as days
$
3.00
CAD
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0.00
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Block Baby & Buddy Bundle New
Block Baby & Block Buddy at a bundle price
$
243.04
CAD
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4mm Exercise/Yoga Mat
Color Blue Generic 4mm thick 60cm wide 172cm long
$
10.00
CAD
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0.00
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10mm Block Therapy Mat
thicker & wider than the average mat 10mm thick 66cm wide 180cm long
$
60.00
CAD
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0.00
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Exercise Bands Latex - 5 Pack
5 Pack varying intensity resistance loop bands made of latex (subject to availability)
$
15.00
CAD
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0.00
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Resistance Band Fabric - 1 Band
1 Fabric Resistance Band 15-20 lbs (subject to availability)
$
10.00
CAD
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1 Resistance Non-loop Band - Latex Free
24 - 30 lbs resistance (1 band) 5 feet in length - 75mm thick - 15cm wide (subject to availability) Non loop band
$
5.00
CAD
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0.00
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IN PERSON - Single Block Therapy Class
Block Therapy Class
$
20.00
CAD
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0.00
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ONLINE - Single Block Therapy Class
Block Therapy Class - Online live class
$
15.00
CAD
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0.00
CAD
5 Class Pass Subscription/Punch Pass In Person
Block Therapy Class - Use for any Regular Public Block Therapy Class
$
85.00
CAD
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0.00
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5 Class Pass Subscription/Punch Pass ONLINE
Use for any Regular Online Block Therapy Class - Online live class
$
68.00
CAD
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0.00
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10 Class Pass Subscription/Punch Pass In Person
Block Therapy Class - Use for any Regular Public Block Therapy Class
$
155.00
CAD
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0.00
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10 Class Pass Subscription/Punch Pass ONLINE
Use for any Regular Online Block Therapy Class - Online live class
$
124.00
CAD
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0.00
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5 Class Pass Subscription/Punch Pass In Person
Group Resistance Training - Use for any Regular Public Fitness Class
$
55.00
CAD
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0.00
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5 Class Pass Subscription/Punch Pass ONLINE
Group Resistance Training - Use for any Regular Online Fitness Class - Online live class
$
35.00
CAD
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0.00
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10 Class Pass Subscription/Punch Pass In Person
Group Resistance Training - Use for any Regular Public Fitness Class
$
100.00
CAD
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$
0.00
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10 Class Pass Subscription/Punch Pass ONLINE
Group Resistance Training - Use for any Regular Online Fitness Class - Online live class
$
60.00
CAD
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$
0.00
CAD
1 In Person Fitness Class Gift Card
Good for 1 In Person Fitness Class via Gift Card (valued at $12)
$
12.00
CAD
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1 Online Block Therapy Class Gift Card
Good for 1 Online Block Therapy Class via Gift Card (valued at $15)
$
15.00
CAD
Quantity
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1 In Person Block Therapy Class Gift Card
Good for 1 In Person Block Therapy Class via Gift Card (valued at $20)
$
20.00
CAD
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$50 Fitness with Jen Gift Card
Good for $50 worth of any Fitness with Jen service Gift Card (valued at $50)
$
50.00
CAD
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5 In Person Fitness Class Pass Gift Card
Good for 5 In Person Fitness Class Pass via Gift Card (valued at $60)
$
55.00
CAD
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5 Online Block Therapy Class Pass Gift Card
Good for 5 Online Block Therapy Class Pass via Gift Card (valued at $75)
$
68.00
CAD
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5 In Person Block Therapy Class Pass Gift Card
Good for 5 In Person Block Therapy Class Pass via Gift Card (valued at $100)
$
85.00
CAD
Quantity
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10 In Person Fitness Class Pass Gift Card
Good for 10 In Person Fitness Class Pass via Gift Card (valued at $120)
$
100.00
CAD
Quantity
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10 Online Block Therapy Class Pass Gift Card
Good for 10 Online Block Therapy Class Pass via Gift Card (valued at $150)
$
124.00
CAD
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10 In Person Block Therapy Class Pass Gift Card
Good for 10 In Person Block Therapy Class Pass via Gift Card (valued at $200)
$
155.00
CAD
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Credit Card
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