Willows Squash and Fitness Centre

Myzone Testing Package

Client 1

Client Details

Attendee First Name

Attendee Last Name

Email Address

Confirm Email Address

Mobile/Cell

Myzone Testing Dates

From 01-Nov-2019 to 25-Dec-2019

DISCLAIMER:
Contact Willows Reception to collect your Myzone Heartrate unit and book your Testing session.

Agreement

Signed

Date

/ /

Payment Method

There are no refunds for any enrolments into Willows Squash and Fitness Centre related programs. When you sign/tick confirmation for this enrolment you are acknowledging that you know this as a fact and have accepted it as a condition.

Cost

$149.00 per session

Cost Per Person

$149.00

Total Cost

Group Discount

Promo Code

Promo Code Discount

Grand Total

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)