Join Functional Fit

Application form for Energise Membership, just $33.90 per week

Personal Details

Physical Address

Postal Address (if different)

Emergency Contact

Membership Information

Energise Membership

Bank Details

AUTHORITY TO ACCEPT DIRECT DEBITS

(Not to operate as an assignment or agreement)

Authorisation Code: 0302448

Promo Code

Final Declaration

You warrant, declare and acknowledge that:

  1. The information given by you in entering this Direct Debit Request And Customer Contract is correct and will be relied upon by us.
  2. You have read this agreement, including the terms and conditions here, before accepting them below.
  3. This agreement will become binding upon all parties once you have ticked in the "I agree" box below and the "Join Now" button has been clicked.

Application form for Energise Membership, just $33.90 per week

An initial admin fee of $15 will be added to the first payment making it $48.90, and then $33.90 thereafter

The first debit will be processed in the first week of opening

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