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Membership
Details
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Club
The Strength Den
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Cell Phone
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Suburb
City
State
Postal Code
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Emergency Contact
First Name
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YES / NO Has your doctor ever told you that you have a heart condition or have you ever suffered a stroke?
Yes
No
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/
Yes
No
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
Membership
Under 18 Membership
Price
$25.00 Fortnightly by Billing
Please Note: eDebit charges an additional fee for bank account debits and credit cards.
Please Note: eDebit charges an additional fee for bank account debits.
Please Note: eDebit charges an additional fee for credit cards.
Signup Fee
$10.00
Membership Start Date
First Payment Date
Prorated Upfront Fee
Cooling Off Period Start
23/08/2019 08:37PM
Cooling Off Period End
23/08/2019 08:37PM
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