Application Form

Membership Application Form

£65 Monthly Direct Debit - No Contract - Minimum Age 16
Name*

First NameLast Name
Address*

Addrees 1

Address 2

TownCounty

Post Code
Date of Birth*

DayMonthYear
Phone Number*
E-mail*
Emergency Contact Name*

First NameLast Name
Emergency Contact Phone Number*
Take Photo If Possible
Signature Accepting, Health Commitment Statement, Liability Waiver & Terms and Conditions of Membership.*
Date You Wish Membership To Start*

DayMonthYear
Current Months First Direct Debit Taken Immediately*
Get Date
Day of the Month
The current months membership amount shown above will be taken immeidately by direct debit and has been discounted depending on day of the month you wish your membership to start.

All future direct debits will be for £60 per month starting next month and payments will be taken on the 1st of each month.

Please ensure you fill out the Direct Debit on the confirmation page, please click on the Direct Debit link. If more than one person is joining and you wish the payments to come out of one account only one direct debit form needs to be filled in.

Your welcome letter that you need to book your gym induction will be emailed to you on submission of the membership application. Thank you for joining us here at Watersplash!
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Membership Application Form