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You have selected a
Foundation Monthly Membership
at a cost of £36.00 per month at the City Baths Newcastle site.
Your details
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D.O.B
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I wish to hear about the following items:
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Please confirm by entering into the contract with us you agree to receiving communication regarding your accounts, subscriptions, and participating activities. You may receive service messages. Your data may be shared with third parties for agreed data processing such as the collection of subscription fees. Please refer to our privacy policy for more details. To read the privacy policy click
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Step 2.
Your details
Name:
Pal Kienitz
Edit
Email:
pal.kienitz@dcslsoftware.com
Mobile:
12345678
Your health
Set all to "Yes"
Set all to "No"
Has your doctor ever said you have any heart condition and that you should only do exercise/physical activity recommended by a doctor?
Yes
No
Do you feel pain in your chest when you do exercise/physical activity?
Yes
No
In the past month have you had chest pains when you were not doing exercise/physical activity?
Yes
No
Do you lose balance because of dizziness or do you ever lose consciousness?
Yes
No
Do you have a bone or joint/back problem which could be made worse by a change in your exercise/physical activity?
Yes
No
Is your doctor currently prescribing medication for your blood pressure or heart condition?
Yes
No
Any other significant illness, recent or serious operation?
Yes
No
Do you know of any other reason why you should not exercise or do physical activity?
Yes
No
"Yes" was selected for one of the options. By proceeding you confirm you have consulted with your doctor and are safe to join the gym
I confirm
I do not confirm
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Step 3.
Your health
See my
member healt declaration
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Payment
When do you want your membership to start?