MyZone Online Purchase
Client 1
Client Details
Myzone Belt Online Purchase Dates
From 05-Dec-2017 to 31-Dec-2018
DISCLAIMER:
You may Pick up your Myzone from Willows Reception in 24hrs. It will be fully charged, loaded with your provided details and ready for use.
Agreement
/ /
Payment Method
No Refunds. Your order will be terminated if payment is not received within 24hrs. If MyZone is faulty please see MyZone support at www.myzonemoves.com
$109.00 per session
Credit Card (Ezidebit)
Please mail this form with a payment attached to: "Willows Health & Lifestyle Centre, 55-57 Kitchener Street , Toowoomba QLD 4350"
MyZone Online Purchase Portal Details
Please fill out the following details to set up your Myzone profile
Name?
Email?
Password for your Myzone Profile Login.
Date Of Birth
Height (cms)
Weight (kgs)
Name for display on TV Screens (Maximum of 8 Characters)