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Membership
Details
Terms & Conditions
Payment
Confirmation
Your Personal Details
Club
The Strength Den
First Name
Last Name
Date of Birth
Gender
Male
Female
other
Email
Password
Confirm Password
Cell Phone
Home Phone
Work Phone
Street
Suburb
City
State
Please select an option
Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
Victoria
Western Australia
Postal Code
Country
Australia
Occupation
Emergency Contact
Name
Phone
Email
Relationship
Behavioral Information
YES / NO Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?
No
Yes
YES / NO Do you ever experience unexplained pains in your chest at rest or during physical activity/exercise?
No
Yes
YES / NO Do you every feel faint or have spells of dizziness during physical activity/exercise that cause you to lose balance?
No
Yes
YES / NO Have you had an asthma attack requiring immediate medical attention at any time over the last 12 months?
No
Yes
YES / NO If you have diabetes (type 1 or type 2) have you had difficulties controlling your blood glucose in the last 3 months?
No
Yes
YES / NO Do you have any diagnosed muscle, bone or joint probems that you have been told could be made worse by participating in physical activity/ exercise?
No
Yes
YES / NO Do you have any other medical condition(s) that may make it dangerous for you to participate in physical activity/
No
Yes
Checking YES to any of the previous 7 questions will require a consultation from a registered GP to begin any training. Failure to seek further consultation is at the risk of the member or user.
Start Date
First Payment Date
promo_impact_start_date
Membership
New year New you 1 month membership
Price
$70.00 Full Cost by Billing, Fixed Term
Promotion
$0.00 until
Account Credit
applied after sign-up
Membership Start Date
Membership Length
1 months
Prorated Upfront Fee
Transaction fees may apply
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