Theodore Gym Membership Form

Theodore Gym Membership Application

To apply for gym membership please complete all questions.
Member Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState

Post CodeCountry
Member Contact Number
Format: (000) 000-0000.
E-mail
example@example.com
Member Date of Birth

DayMonthYear
Member 2 Name (Family Membership only)

First NameLast Name
Member 2 Contact Number (Family Membership Only)
Format: (000) 000-0000.
Member 2 E-mail (Family Membership Only)
example@example.com
Member 2 Date of Birth (Family Membership Only)

DayMonthYear
Membership Type
Payment Options-
Please read Theodore Community Link Gym Users Policy, Rules and Regulations below before completing your application.
Do you have any medical conditions? (Asthma, Diabetes, Pregnancy, Heart). Please list.
Have you had any recent surgeries or injuries? (Back, neck, heart, reconstructions...)
I agree to be bound by the Policy, Rules and Regulations of Theodore Community LinkIncorporated Community Gym. I am aware that I can ask for a copy of these policies,rules and regulations at any time. I acknowledge that it is recommended that I receive a gym orientation session and a health check/screening session before commencing work in the gym.
If you need to pay with an alternative method, please contact the Coordinator.

A payment processing fee of 2.2% will be added to credit card payments.
Date of Signature

DayMonthYear
Date
Signature
Any questions regarding membership please contact Theodore Community Link

Email coordinator@theodorelink.com

For urgent queries - 0438 438 492 - Nita

Membership Types

Should be Empty:

Theodore Gym Membership Application

Membership Types

Credit Card