The Pride Gym - Weekly PAYG Form

The Pride Gym

Weekly Membership - Step 1 of 3

Weekly PAYG Membership

Price: £ 15.00

Name *

First

Last

Phone *

Date of Birth *//

Email *

Email

Confirm Email

Ensure this is a real email! We need to see proof of your emailed receipt.

Address

Address Line 1

Address Line 2

City

State / Province / Region

Postal Code

Exercise Goals *

Have you ever had or suffered from any of the following?

If you answered 'Yes' you must seek consent to train from your GP.

Are you pregnant? (Women only)

Emergency Contact *

First

Last

Please enter the details of the person to be contacted in case of emergency

Stripe Credit Card *

Card

Name on Card