Temporary HiiT Class Sign Up Form (Credit Card)

Name*

First Last

Email*

Phone*

Address*

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code

Date of birth*

Outdoor Hiit Training*

Start date*

What date would you like your first payment to come out? For those preferring a specific day or fortnightly please ensure you select the correct date to begin payment.

Total

$ 0.00

Did you have any further questions we can help with?

Note: This membership will automatically be cancelled on your request or once we are allowed to use the facility inside ... once inside if you weren’t already a member of Micks HiiT and you wish to continue training with us and get the full experience your rate will be adjusted to the currently membership price $34.95 PW

Payment Details

Would you like to use your account details from your current membership for billing ?*

Yes
No

Credit Card Number*

Card Type*

Mastercard
Visa
Amex

Expiry Date*

Enter as MM/YY

Name On Card*

Total

$ 0.00

Terms & Conditions*

Waiver Of Liability For Gym Use
I hereby understand and acknowledge that the training, programs and events held by Micks’s Gym Pty Ltd may expose me to many inherent risks, including accidents, injury, illness, or even death. I assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me. I also hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity, I acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in. After having read this waiver and knowing these facts, and in consideration of acceptance of my participation and Mick’s Gym Pty Ltd furnishing services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE Mick’s Gym Pty Ltd, its officers, agents, employees, organizers, representatives, and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in Mick’s Gym Pty Ltd training, programs and/or events. By my signature below indicate that I have read and understand this Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.

Please confirm you've read the General Terms & Conditions
I agree to the waiver above

Temporary HiiT Class Sign Up Form (Credit Card)

Temporary HiiT Signup (Credit Card)

Payment Details