16 - 17 Club Gym Joining Online Form

16 – 17 Club Gym Joining Form

This form is to be filled out on site with a Fitness Instructor. Please fill out the PARQ form prior to filling out this form

Step 1 of 2

16-17 Club Member

This form is to be filled out on site. Please each fill out our PARQ form prior to filling out this form

Name(Required)

First Last

Address

Street Address Address Line 2 Town County Postcode

Date of Birth(Required)

Phone(Required)

Email Address

Have you filled out our Fitness Health PARQ/T&C form?(Required)

Yes

Please note that by ticking this box you are confirming that you have consent from your GP to use our gym, and agreeing to our T&Cs

Legal guardian and supervising adult

(If the legal guardian is unable to attend the site, this section must be read out loud over the phone and completed with them). 16-17 year olds can use the gym as PAYG or monthly paying members, to sign up, we need verbal consent from the legal guardian, this can be over the phone, but preferably would be in person. 16-17 Year olds must have 1 compulsory 30m inductions. 16-17 Year olds must not use barbells, the squat rack or heavy weights. Appropriate weights will be discussed in your inductions and a Hampton Pool fitness instructor must be present if the 16-17 year old would like to progress the weights used, after the induction.

Name(Required)

First Last

Address

Street Address Address Line 2 Town County Postcode

Date of Birth(Required)

Phone

Second Emergency contact name(Required)

First Last

Please note, this should be someone other than yourself, in the circumstance we are unable to get hold of you

Second Emergency contact number(Required)

Please note, this should be someone other than yourself, in the circumstance we are unable to get hold of you

Which payment method is the 16-17 Club member going to use(Required)

PAYG

Monthly (No Join Fee)

Annual (No Join Fee)

Please note, for Gym PAYG memberships a joining fee is required

Legal Guardians E-Signature(Required)

If unable to come, the parent or guardian can give verbal permission over the phone and the instructor or receptionist can sign on their behalf

Staff members name who is assisting in the sign up

First Last

(If a fitness instructor is not available, any member of staff can assist in the sign up confirming that the legal guardian has given verbal permission for the minor to join the gym and reception can assist with booking the minor in for their first induction)

Today's Date(Required)

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16 – 17 Club Gym Joining Form

16-17 Club Member

Legal guardian and supervising adult