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Membership
Details
Terms & Conditions
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Confirmation
Your Personal Details
Club
Mitre 10 Mega Amberley Fitness Centre
First Name
Last Name
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Male
Female
Email
Password
Confirm Password
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Suburb
City
State
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Country
New Zealand
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Google Adwords
Leaflet Drop
Mall Promotion
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Emergency Contact
Name
Phone
Email
Relationship
Medical Information
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Start Date
First Payment Date
promo_impact_start_date
Membership
Youth/Senior/Com Card 3 months
Price
$166.00 Full Cost
Tag
$20.00
Promotion
$0.00 until
Account Credit
applied after signup
Membership Start Date
Membership Length
3 months
Prorated Upfront Fee
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