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Gym Membership Application Form

Home Gym Membership Application Form
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- Step 1 of 6

PERSONAL INFORMATION

Title *
Name *
Date of Birth *
Address *

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

Date
Date

EMERGENCY CONTACT INFORMATION

Name *

HOW DID YOU HEAR ABOUT TNDO FITNESS

HOW DID YOU HEAR ABOUT TNDO FITNESS

GENERAL FITNESS EVALUATION REPORT

History or family history of heart disease? *
High blood pressure or medicated for same? *
Diabetes / Mellitus? *
High Cholesterol? *
Incidents of seizure, blackout or fainting? *
Asthma / Respiratory disease? *
Recent surgery / Chronic disease? *
Pregnancy within the last 3 months? *
Back, joint or muscle disorder? *
Taking any medication or substance? *

(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.

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 *
Address *
Date of signing *

Stripe Payment

TNDO Gym Membership Plans *
Type of payment recurrent *
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Address

TNDO Fitness

Unit 1
Gaelic Street
Ossory Road
Dublin 3

Contact Details

Email: [email protected]

Opening Hours

24 hours 7 days a week

Reception times
Monday-Thursday
4pm-7pm
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