Customer Registration Form

Customer Registration Form
Customer Details:
Full Name*

First NameLast Name
Address*

Street Address

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CityState / Province

Postal / Zip Code
Phone Number*

Area CodePhone Number
My Products*
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15 Minutes Sports Massage
One muscle group

£17.00 Quantity



30 Minutes Sports Massage
Legs or back

£27.00 Quantity



45 Minutes Sports Massage
Two muscle groups

£42.00 Quantity



1 Hour Sports Massage
Full body (shoulders, upper and lower back and leges) or client choice of areas.

£47.00 Quantity



Massage Package 1
Two 1 hour Massage per week

£82.00 Quantity



Massage Package 2
Three 1 hour Massage per week

£112.00 Quantity



Massage Package 3
Two 30 minutes Massage per week

£42.00 Quantity



Massage Package 4
Three 30 minutes Massage per week

£57.00 Quantity



Personal Training Sessions per Hour
Enter description

£32.00 Quantity



Personal Training Recommended Per Month
4 hours of personal training per week

£450.00 Quantity



Personal Training Package 1 Per Month
1 hour of personal training session per week

£122.00 Quantity



Personal Training Package 2 Per Month
2 hours of personal training sessions per week

£242.00 Quantity



Personal Training Package 3 Per Month
3 hours per week (beginner) plus one free 15 minutes sports massage per week.

£302.00 Quantity



Personal Training Plus Sports Massage Package 4 Per Month
2 hours personal training sessions plus 1 hour sports massage per week (back and hamstrings)

£302.00 Quantity



Personal Training Package 5 Per Month
Amateur to Advance 6 hours per week plus one free 15 minutes sports massage per week

£602.00 Quantity



Superprof Clients Only
Personal Training Session per hour

£20.00 Quantity



Written Training Plan (self-delivered) - 1 Day Plan
This is a 1 hour written training plan to be self delivered by the client.

£15.00 Quantity



Written Training Plan (self-delivered) - 3 Days Plan
These are plans written for 3 different days for 1 hour duration each day to be self delivered by the client.

£40.00 Quantity



Written Training Plan (self-delivered) - 5 Days Plan
These are plans written for 5 different days for 1 hour duration each day to be self delivered by the client.

£65.00 Quantity



One month Written Training Plan Package 1
Training plans written for 3 different days per week progressively. In total, 12 progressive self-delivered training plans for the month.

£160.00 Quantity



One month Written Training Plan Package 2
Training plans written for 5 different days per week progressively. In total, 12 progressive self-delivered training plans for the month.

£260.00 Quantity



Appointment Only
This is for consultations and if payment was made for a weekly or monthly plan.

£ Free Quantity



Total

£0.00
NB* if a written plan is required, select appointment date to indicate when plan is required for. A 1 day notice period is required.
Appointment*
E-mail*
example@example.com
Please provide specific information about the services you require (e.g body part for massage or personal fitness goal)
Additional Forms to Complete
Complete this form if you are doing massage: Client Consultation Form: https://form.jotform.com/251073759609364

Complete this form if you are doing Personal Training: Physical Activity Readiness Questionnaire: https://form.jotform.com/251072596150050

Complete this form if you are doing Personal Training: Informed Consent Form: https://eu.jotform.com/sign/251072772522049/invite/01jt1cwfqebe4a02abb33a89b2

Complete this form if you are doing Personal Training: Waiver, Release and Assumption of Risk Form: https://eu.jotform.com/sign/251072746151048/invite/01jt1d0cph3a9b28ee4157a9ed
How did you hear about us?*
Please Specify*
Suggestions if any for further improvement:
Training & Session Locations

Gym: I currently operate out of EnergieFitness Gym (Basement Unit, Harpur Centre, Horne Ln, Bedford MK40 1TS),where our personal training and Massage sessions will typically take place. Please note that clients will be required to register as members of the gym inorder to access its facilities. Client Home or Other Suitable Locations: Clients may request massage or personal training sessions at their own home or another suitable location. However, for certain personal training sessions, clients must ensure they have the appropriate equipment available. Additionally, any travel expenses incurred for off-site sessions will be the responsibility of the client.