Membership Options for Every Body

If you could devise your own Gym Membership, I can imagine you would pay NO JOINING FEE, it certainly would NOT BE A CONTRACT, you would like the flexibility of freezing your membership while on holidays or if you need time off for an injury or such and of course there would be no fees in that, you would like to be able to walk in the door ANYTIME you desire (24/7) there would be NO CANCELLATION FEE OR 30 DAY CANCELLATION policy, in fact you would love to be able to cancel it virtually within 24 hours rather than 30 days!

Then welcome to Kennedys Gym memberships because all of the above is EXACTLY how it works at Kennedys!

Check out the table below which explains some basic options and if you have any further questions, feel free to pop in anytime to discuss your thoughts, or email us or call 97761965!

  • Gym
    $14.95 Weekly
    • Unlimited Gym
    • No Contracts
    • Plus More...
  • Gold
    $29.95 Weekly
    • Unlimited Gym
    • Unlimited Small Group Training
    • No Contracts
    • Plus More...
  • PT Plus
    $49.00 Weekly
    • Unlimited Gym
    • Weekly 1 on 1 Personal Training Session
    • No Contracts
    • Plus More...

X

PERSONAL & CONTACT DETAILS

First Name:
Surname:
Date of Birth:*Must be 18yrs or older for 24/7 access
Email:
Mobile:
Address:

EMERGENCY CONTACT DETAILS

Contact Name:
Contact Number:
Relationship to You:
Name of G.P.:
Contact Number:

HEALTH QUESTIONS

Please answer by choosing YES or NO for each question. Failure to disclose relevant information may put your safety at risk.

Have you EVER had Asthma, used inhaler medication or been troubled by shortness of breath?

YesNo
Do you have diabetes or raised blood sugar levels?

YesNo
Have you EVER had epilepsy, experienced fits, seizures, convulsions, fainting or blackouts?

YesNo
Have you EVER had heart disease, heart murmur or irregular heart beat?

YesNo
Do you experience chest pain or angina?

YesNo
Have you EVER been told you have raised blood pressure or cholesterol?

YesNo
Have you EVER had injuries that have led you to see a medical practitioner?

YesNo
Have you EVER been diagnosed with hepatitis or any other blood disorder?

YesNo
Have you EVER suffered mental illness, depression, anxiety or stress?

YesNo
Have you EVER suffered from Arthritis or any bone or joint problem?

YesNo
Have you EVER undergone any operation?

YesNo
Have you EVER had a shin splint or broken bones?

YesNo
Are you currently receiving treatment for any health condition?

YesNo
Are you taking any prescribed medications?

YesNo
Do you know of ANY other circumstances regarding your health and fitness that MIGHT make you unable to carry out any exercises conducted during the session?

YesNo
Comments:

If you have answered YES to any of the health questions you may need to obtain a clearance from your medical practitioner (if condition is ongoing) relating to the condition stating you are able to undertake training without risk to the condition worsening. If you are unsure please ask Kennedy’s Health & Fitness for clarification.

LIFESTYLE EVALUATION

Do you smoke?

YesNo
If Yes, how many / day

Do you drink alcohol?

YesNo
If Yes, how many glasses

and frequency?
Do you drink caffeine?

YesNo
If Yes, what do you consume predominantly

and how much?
On a scale of 1-10 daily how do you feel about your current energy level? (10 being amazing)

On a scale of 1-10 daily how do you feel about your body shape? (10 being very happy)

For both of the above how would you like to feel about yourself?

Are you currently training?

YesNo
If Yes - Where and for how long?

If No - How long has it been since you last trained and why did you stop?

What are your current training goals, purpose, objectives?

What is your occupation?

How would you class your work life and personal life overall?

SedentarySemi ActiveActive
Active Hobbies – Please list 3:

MEMBERSHIP TYPE

Gym Membership ($14.95 weekly)Gold Membership ($29.95 weekly)PT Plus Membership ($49.00 weekly)

CREDIT/DEBIT CARD DETAILS

Card Number:
Expiration Date:
CCV:

Signature:
Date:
Staff Member Signature:
Date:

We thank you for taking the time to complete this questionnaire. We hope you enjoy your time here at Kennedy’s Health & Fitness and look forward to helping you on your Health & Fitness Journey!