6 Month Sign Up

PERSONAL INFORMATION

If you are a minor please fill out the first section.

Parent / Guardian Signature

Minor Signature

Date

First Name*

Surname*

Address 1*

Address 2

Address 3

Phone*

Mobile*

Work*

Email*

D.O.B

Age*

EMERGENCY CONTACT INFORMATION

First Name*

Surname*

Phone*

Mobile*

HOW DID YOU HEAR ABOUT TNDO FITNESS

Untitled

Advertising

Passing By

Word Of Mouth

Other

Specify

INDUCTION TO GYM CARRIED OUT BY:

Staff Member

Date

I confirm that I have waived the offer of a gym induction and declare myself fully competent in all aspects of gym use.

Member

Date

GENERAL FITNESS EVALUATION REPORT

Other:

(If you answer yes to any of these questions, a G.P.'s clearance may be required before exercising) *Please Note: Should any answer to the above change during the customers period of use, the onus is on the customer to inform the centre in order to amend the form and appropriate action can be taken. Members are requested to accept responsibility for their personal, medical and physical condition in order to to to take part in the centre activities including the use of the gym equipment. Any assessment undertaken in the centre is for general information only with a view to giving advice and should not relied on by members as certifying their fitness or otherwise to use the clubs facilities or equipment. The centre advises all members to consult with their doctor prior to beginning a program of physical exercising. On joining the member automatically accepts and agrees to the terms and conditions of the membership.

I

Hereby waive waves any right of action against TNDO Fitness or its servants or agents arising from my use (or that of my department) of any of TNDO facilities at Unit 1, Gaelic Street, Ossory Road, dublin 3. I declare that I intend to use the facilities at my own risk and that TNDO Fitness accepts no responsibility whatsoever for any injuries occurring during or after such use. I agree that I have read, understood and agree the contents of this informed consent agreement and the rules for the facility as posted in the reception area, in their entirety.

SEPA Direct Debit Mandate

Name

First

Last

Address Line 1*

Address Line 2*

City/Postcode*

Country*

Account Number (IBAN)*

Swift BIC*

Type of payment recurrent*

Yes

Date of signing:*

Signature(s)*

This field should be left blank

PERSONAL INFORMATION

EMERGENCY CONTACT INFORMATION

HOW DID YOU HEAR ABOUT TNDO FITNESS

INDUCTION TO GYM CARRIED OUT BY:

GENERAL FITNESS EVALUATION REPORT

SEPA Direct Debit Mandate

Address

Contact Details

Opening Hours