Myers Fitness Centre Registration Form

REGISTRATION
SEE QUESTIONNAIRE BELOW.

PLEASE DISREGARD PAYMENT OPTION BELOW IF YOU HAVE ALREADY MADE PAYMENT OR WILL BE USING OTHER PAYMENT METHODS.

NOTICE:

Registration fee is paid only by cash. If you are signing up online, please feel free to go ahead and pay your gym fee and pay your registration fee when you arrive at the gym

THIRD PARTY TRANSFER

BNS ACCOUNT INFORMATION

MYERS FITNESS CENTRE

SCOTIA BANK OCHO RIOS

BUSINESS ACCOUNT

ACCOUNT#:600674

CHECKING ACCOUNT

SCOTIA ONLINE

REGISTRATION FEE $1500

1 MONTH GYM FEE MEMBERSHIP $8000

3 MONTHS GYM FEE MEMBERSHIP $22000

6 MONTHS GYM FEE $48,000

1 YEAR GYM FEE $70,000

PERSONAL TRAINING FEE $1500 - $$3500

SPIN/BOXING/REBOUND $1000
What is your name?

First Last
What is your gender?
Date of Birth

MonthDayYear
Date
What is your email address?
example@example.com
What is your home address

Street name

Street name Line 2

CityParish

Zip Code
Phone Number

Area CodePhone Number
Job Title
"Please specify the organization you work for as well"
Emergency Contact

First NameLast Name
Emergency Contact Phone Number

Area CodePhone Number
PLEASE SELECT A PACKAGE
CUSTOMIZE YOUR PACKAGE
SELF ASSESSMENT INFORMATION
Have you done any workout programs before?

YesNo
Please specify which workout programs have you done?
When was the last time you have participated in physical fitness programs?

1 Month Ago2 Months AgoN/AOther

How do you rate yourself in terms of fitness?

	1	2	3	4	5	6	7	8	9	10

1 is Worst, 10 is Best

What are your goals?
"What do you hope to achieve by joining the gym"
MEDICAL INFORMATION
Are there any illnesses, medical or physical condition or have you ever done surgery that may have a negative impact while exercising?(Please specify below)
Please provide the details and frequency of dosages. Enter N/A if none (Please answer truthfully as failure to provide truthful information in regards to your medical history that could be made worst by working out could result in severe injuries. Be cautious, clients workout at their own risk, Myers Fitness Centre will not be held accountable for any injuries that may be sustained while using the facility).
DISCLAIMER
Scroll down to submit form. CONTACT US @ (876) 441-2032/ (876) 858-7136 (876) 622-3887/ 876-437-6925 myers.fitness.ochorios@gmail.com
DO NOT FILL OUT THIS SECTION.

PLEASE SET AN APPOINTMENT TO GET YOUR ASSESSMENT DONE.
BICEPS

CHEST
ABS

HIPS
LEGS

LBS
NOTICE

Please ask about your free meal guide, clients benefits, class schedule, and for any other clarity please feel free to visit our website at myersfitnesscentre.com
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REGISTRATION