Gym Membership

Members Details

Member Name*

First Last

Membership Options*

Please select the membership that most applies to you.

Gender

Date of Birth*

Address*

Street Address Address Line 2 City County / State / Region ZIP / Postal Code Country

Home Phone

Emergency Contact

(Please provide details of Name, Relationship and Contact number)

Email*

Heath & Medical Questionnaires

This questionnaire has been designed to identify any physical or medical conditions that may prevent the member from carrying out any strenuous exercises.

Has your doctor ever said that you have a heart condition?*

Yes
No

If Yes, please specify

Do you have chest pain brought on by physical activity?*

Yes
No

Have you developed chest pain in the last month?*

Yes
No

Do you ever feel faint or have spells of severe dizziness?*

Yes
No

Do you have any bone or joint problems, which have been aggravated by exercise or might be made worse with exercise?*

Yes
No

Are you currently taking any medication?*

Yes
No

Are you pre/post natal?*

Yes
No

Are you currently pregnant or have been within the last six months?*

Yes
No

Do you suffer from asthma or breathing difficulties?*

Yes
No

Do you suffer from diabetes?*

Yes
No

Do you suffer from epilepsy?*

Yes
No

Do you suffer from raynaud's disease?*

Yes
No

Do you have any sports injuries?*

Yes
No

If you answered YES to one or more questions, please provide more details below. It is advisable that you consult your Doctor BEFORE increasing your physical activity. Please inform your Doctor which questions you have answered yes to find out the kinds of activities that would be most suitable.

Photography & Marketing Material

Photographs and film/video may be taken of members during sessions times. This material may appear in our Internal publications, external marketing such as in a local paper, on the Ardingly website and through our social media platforms.

Marketing Permissions*

YES - I hereby give permission for photographic images/video to be used for Marketing purposes.
NO - I am not willing for photographic images/video to be used for Marketing purposes.

Cancellations & Amendments

As this booking forms part of a year's membership, one month's notice is required for any cancellations. Please email any changes to fitness@ardingly.com

GDPR Agreement

I consent to Ardingly Active storing submitted information from this booking form.

(This information will only be used to promote any Ardingly Active deals or courses.)

Terms & Conditions*

I confirm that I have read the Ardingly Active Terms and Conditions.

(Terms & Conditions are available to view on the Gym Membership page)

Ardingly Active

The state-of-the-art Strength & Conditioning Centre opened in 2017 and consists of a mix of cardio, free weights and strength training equipment.

Memberships

Opening Hours

Gym Membership Form

Members Details

Heath & Medical Questionnaires

Photography & Marketing Material

Cancellations & Amendments

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