Local One Day Trial

Local One Day Trial

Thank you for visiting Transform Active. Fill in this form to initiate a complimentary one day trial for locals. We are Transform Active, the home of holistic fitness in Mullumbimby. Our 22 group classes, state-of-the-art facilities, and skilled trainers are designed to help you reconnect with your body and mind.
Full Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Staffed hours
- Monday to Thursday: 7:30 AM - 5:30 PM
- Friday: 7:30 AM - 4:00 PM
- Saturday: 7:30 AM - 10:30 AM
What date and time during our staffed hours suits you? *
What kind of training (strength, flexibility, mobility, functional, etc) are you interested in? What are your goals (weight loss, muscle gain, maintenance, etc)?
Are you interested in Personal Training?*

YesNo
Has your medical practitioner ever told you that you have a heart condition or have you ever suffered a stroke?*

YesNo
Do you ever experience unexplained pains or discomfort in your chest at rest or during physical activity/exercise?*

YesNo
Do you ever feel faint, dizzy or lose balance during physical activity/exercise?*

YesNo
If you have diabetes (type 1 or 2) have you had trouble controlling your blood sugar (glucose)in the last 3 months?*

YesNo
Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?*

YesNo
Do you have any other conditions that may require special consideration for you to exercise?*

YesNo
By completing this form you agree to the gym rules and will follow them during your time at our gym:

1. No bags on the gym floor.

2. Closed in shoes must be worn at all times (even when doing lifts).

3. A towel must be used at all times. No towel, no train.

4. Equipment needs to be wiped down after use.

5. All equipment is to be put away back where it belongs.

A staff member will be in contact with you ASAP to confirm your complimentary trial. We look forward to seeing you in the gym, and supporting you to begin your wellness journey. :)

Be safe and have fun.
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