Your Gym Name
photo
Membership application form
Form no. ________ Date: ____ / ____ / ________
Full name:
Father's / husband's name:
Date of birth:
Mobile number (WhatsApp):
Address:
Emergency contact name and number:
ID type and number (optional):
Gender: □ Male □ Female □ Other
Goal: □ Weight loss □ Muscle gain □ Fitness □ Other ________
Plan and fee
Plan: □ 1 month □ 3 months □ 6 months □ 12 months □ Personal training
Fee ₹Paid ₹Due ₹
Start date:Expiry date:
Paid by: □ Cash □ UPI □ Card □ Bank transfer
Health declaration
Do you have or have you had any of these? Tick all that apply.
- □ Heart or blood pressure problem
- □ Diabetes
- □ Asthma or breathing problem
- □ Back, knee or joint injury
- □ Recent surgery
- □ Pregnancy
Other conditions or medicines:
I confirm the details above are true. I have told the gym about any health condition. I understand that exercise carries a risk and I train at my own risk.
Gym rules
- Fees are paid in advance and are not refundable once the plan starts.
- Carry a towel, wear clean sports shoes and wipe the equipment after use.
- Put weights back in their place. Do not drop them.
- The gym is not responsible for lost belongings. Use a locker.
- Follow your trainer's advice on weights and exercises.
Member signature:
For the gym: