New Customer Registration Form

Member Application Form
Customer Details:
Full Name*

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
E-mail*
example@example.com
How did you hear about us?*

Media Consent
At Evolve, we love capturing moments of connection, celebration, and growth. By signing below, you consent to the use of any photos, videos, or other content captured during Evolve events and activities (including retreats, workshops, and meet-ups) for use on our social media, website, promotional materials, and other digital platforms.

I understand that:

• My image may appear in group or individual content.

• Evolve will use this content in a respectful, empowering, and positive way.

• I can opt out of close-up solo content by notifying staff in advance.
Payment & Direct Debit Authorization
By signing below, I authorise Evolve to debit my account for the membership tier selected above, according to the agreed payment frequency and terms.

I understand that:

• Payments are ongoing until I request cancellation in writing (with a minimum 30-day notice).

• Failed or missed payments may result in paused access to membership benefits or cancellation of membership.

• All fees are non-refundable unless otherwise stated in writing.

My Products*

🔥 Ignite Open the door to a world of growth, connection, and exclusive rewards with our Ignite Membership! What you get: Social Saturdays + Evolve Academy + 20 Evolve points per week + Attend Member Run Events!

$19.00AUD

🌱 Flourish Whether you are here for the learning or connecting with likeminded women, this package has something for you. What you get: All Ignite Inclusions + Momentum Mondays + 60 Evolve points per week + Quarterly Events & Workshops

$59.00AUD

🧘🏼‍♀️ Elevate Take your experience to the next level with Elevate, our premium membership designed for women who want to lead, connect, and maximise their rewards. What you get: All Flourish Inclusions + Host your own events + 100 Evolve points per week + Annual Weekend Retreat!

$99.00AUD Quantity

Total

$0.00AUD

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Community Agreement
Evolve is a safe, inclusive, and supportive space. By joining, I agree to:

• Treat all members with kindness, respect, and confidentiality.

• Be open to personal growth and respectful discussion.

• Uphold the shared values of empowerment, community, and holistic wellness.
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Member Application Form