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Membership
Details
Terms & Conditions
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Confirmation
Your Personal Details
Club
Amberley Fitness Centre
First Name
Last Name
Date of Birth
Gender
Male
Female
Email
Password
Confirm Password
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Home Phone
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Street
Suburb
City
State
Postal Code
Country
New Zealand
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Google Adwords
Leaflet Drop
Mall Promotion
Occupation
Emergency Contact
Name
Phone
Email
Relationship
Medical Information
Behavioral Information
Start Date
First Payment Date
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Membership
Adult Card Holder 12 Month
Price
$598.00 Full Cost
Tag
$20.00
Promotion
$0.00 until
Account Credit
applied after sign-up
Membership Start Date
Membership Length
1 years
Prorated Upfront Fee
Transaction fees may apply
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