Registration

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To become a member of Just Gym Mtunzini:

Please complete the registration form below

Pay your first month’s membership fee into our bank account (Banking Details: FNB Business account no 63001107431 Branch code 220830)
Email proof of payment to justgym.mtunzini@gmail.com
Visit our gym for us to set up your biometric access

Username*

Password*

Confirm Password*

Membership Plan

Member Contact Information

Main Member First Name*

Main Member Last Name*

Main Member Gender*

MaleFemale

Other

Main Member Age

Main Member E-mail Address*

Main Member Mobile Number*

Main Member ID

Main Member Birth Date*

Partner First Name*

Partner Last Name*

Partner Gender

MaleFemale

Other

Partner Age*

Residential Address*

Postal Address*

Emergency Contact First Name

Emergency Contact Last Name

Emergency Contact Mobile Number

Emergency Contact E-mail Address

Emergency Contact Relation

Membership Acknowledgement:

By checking the box below this agreement, I also agree to accept the terms and conditions of this agreement in its entirety, as annotated on the real of this agreement, and to be bound by these conditions for the duration of my membership. I confirm that I have read and understood the terms and conditions of membership.

Main Member Acknowledgement

Yes

Registration Date

Consent Date*

Add Minors*

YesNo

Consent for Minors

Minor 1 First Name*

Minor 1 Last Name*

Minor 1 Age*

Minor 1 Gender*

MaleFemale

Other

Minor 2 First Name

Minor 2 Last Name

Minor 2 Age

Minor 2 Gender

MaleFemale

Other

Minor 3 First Name

Minor 3 Last Name

Minor 3 Age

Minor 3 Gender

MaleFemale

Other

By checking the box below, I certify that I, parent or guardian with legal responsibility for the member do consent and agree to the terms and conditions of this membership agreement including the indemnity release.

Parent / Guardian First Name*

Parent / Guardian Last Name*

Parent / Guardian Address*

Parent / Guardian Acknowledgement*

Yes

Only fill in if you are not human