Welcome To eMbody Fitness - Online Member Sign Up

Selected Home Club: Embody [Club Details]

One Month Trial Membership
Available for First-time users only

Membership Includes:
� Complimentary towel service and amenities
� Full use of all cardiovascular and strength training equipment
� Access to all classes on Group Exercise schedule
� Personal Nutrition Consultation with a Nutritionist
� Personal Fitness Coaching session with a Personal Trainer
� Body Composition Analysis and Report
� Introductory Gravity Training and TRX class

Additional Information:
This one month trial membership is available to individuals 18 years and over. Must be a first time user.

You will not be charged further dues after the trial membership has expired unless you choose to become a member.

Upon your registration, a team member will reach out to you to set up a welcome orientation and issue a personal key fob ($25 refundable deposit).

Initial Payment
Amount due now:

Please complete all of the following fields. You only need to enter 1 telephone contact; when entering a telephone number please enter all 10 digits without any spaces; when entering the postal code please enter all 6 characters without any spaces.
First Name   Last Name   Gender   Date of Birth
    Male Female  
Street Address   Province/State   City   Postal/ZIP   Email (Username)
Home Tel.   Mobile   Emergency Contact   Emergency Tel.   Referral Source

Card Type   Card Number  
Expiry Date   Cardholder Name   CSV [?]
Use address above for billing information
Street Address   Province/State
City   Postal/ZIP

Before finalizing your purchase, please carefully read the following terms and conditions.
General Terms and Conditions

1. By using the club facilities:
i. You acknowledge and agree that eMbody Fitness or its nominees, associates, affiliates or their employees shall not be liable for any damages arising from personal injuries or loss of, or damage to personal property of the member or any guest of the member whether such injury, loss or damage is caused by any act of negligence or omission of staff, management or any other person.
ii. You acknowledge that eMbody Fitness is not staffed at all times. While the premises are equipped with security features, members may be unsupervised and may be alone and/or with other members during these times.

2. All members take sole responsibility for the payment of fees, actions and conduct of their guests while at the club. All guests are required to sign a guest registration and waiver card and may only visit during staffed hours. You expressly assume liability for any guest if they have not been pre-registered and/or signed a guest registration and waiver card.

3. All members are required to have a key fob in order to gain entry to the club. A refundable deposit of $25 is charged and the fob will be issued at the club. The replacement fee for a lost key fob is $25. Key fobs are not transferable to another person. Any abuse of this policy will result in membership termination and forfeiture of any pre-paid amounts.
Electronic Signature

I understand that my electronic signature below constitutes a legal signature confirming acceptance of the membership agreement.

Please sign below