Membership Application Form test

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To apply for membership please complete all questions.* This field is required.Please read and check all boxes in order to get started

I am 18 years or older (You can also fill this form on behalf of a minor, who is under the age of 18 by giving consent on next page as his/her legal guardian)

I am giving my consent to site2gym to fill online membership agreement of Anytime Fitness

I understand that all the information entered in this form is correct to my knowledge

2

Membership Type* This field is required.

Paid in Full (someone from corporate office will call you to take full payment)

Monthly payments, over the time of contract (payments will come out of your bank account every month)

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Name* This field is required.

First Name

Last Name

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Email* This field is required.

example@example.com

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Member's Contact DetailsPlease enter personal details of the member

Mobile phone number

Home Phone Number

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Select your membership option* This field is required.

My Bag

0

18 Month Primary Membership ($49/mon) + Key Fob($59)
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"Monthly Plan" 6 Month Membership ($65) + key fob ($0) $ 65.00 CAD
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"Monthly Plan" 12 Month Primary Membership ($55) + key fob ($0)
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"Monthly Plan" Month to Month (2 Months Minimum) Membership ($80) + key fob ($0)
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Debit or Credit Card

First Name

Last Name

7

Discounted Membership Eligibility

I am Senior with age 60+

I am eligible for add-on membership ( I am related and residing in same residence as primary member at this gym)

I am current enrolled in a school as a Full-Time student

I am not eligible for discounted membership

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Discounted Membership Eligibility

You are eligible for a discounted membership. Please contact club office manager with proof during staff hours Mon-Thur: 11 am - 7 pm and Fridays: 11 am - 5 pm.

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Address* This field is required.

Street Address

Street Address Line 2

City

State / Province

Postal / Zip Code

Country

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Date of Birth* This field is required.

Date

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Upload your picture* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

12

Banking Information (choose one option) * This field is required.

I will visit club managers office to provide my banking information

I will attach a copy of void cheque or banking information with this form

13

Upload your banking information* This field is required.

Drag and drop files here

Select files to upload

Max. file size: 10.6MB

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Current Date

Date

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Age1

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Age2

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Upload Picture (choose one option) * This field is required.

I will visit club managers office to get my picture clicked

I will upload the picture, attached with this form

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Parent/Guardian Information* This field is required.Consent for Under 18 to be filled by Parent/Guardian, gym membership

Parent/Guardian Name

Parent/Guardian Phone

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ACKNOWLEDGEMENT OF RISK AND RELEASE OF LIABILITY* This field is required.Consent for Under 18 to be filled by Parent/Guardian, gym membership

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Parent/Guardian Signature* This field is required.Consent for Under 18 to be filled by Parent/Guardian, gym membership

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MEMBER ASSUMPTION OF RISK AND RELEASE:* This field is required.Please read all before clicking submit button

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CLUB ENHANCEMENT FEE:* This field is required.Please read all before clicking submit button

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AUTO-RENEWAL PROGRAM:* This field is required.Please read all before clicking submit button

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INTERNATIONAL ACCESS AND RECIPROCITY* This field is required.Please read all before clicking submit button

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AUTHORIZATION OF PREAUTHORIZED PAYMENTS:* This field is required.Please read all before clicking submit button

26

SUMMARY OF MEMBERSHIP POLICIES:* This field is required.Please read all before clicking submit button

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ADDITIONAL TERMS AND CONDITIONS* This field is required.Please read all before clicking submit button

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Signature* This field is required.

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Club* This field is required.

Dawson Creek

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Click Submit to continue!

After submitting the form, you will receive 6 digit code to access your key fob from the dispenser within next 1-2 minutes. If you do not receive an email with the code, please make sure to check your spam or junk email folder for an email from info@site2gym.com