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Let's get started

We can't wait to welcome you to our Gym family! To finalise your membership, all you need to do is click the link below to set up your direct debit.

If you would like our help with this, or anything else, please don't hesitate to contact us on [email protected] or +441761 451596.

BECOME A MEMBER

Before you get started, we'd love to know a few bits about you to make sure our team can help you make the most of your membership.

Personal Details

First Name*

Surname*

Address

Postcode*

Date of Birth*

Age

Email*

Phone Number

Emergency Contact Name*

Emergency Contact Phone Number*

Doctor's Surgery*

Doctor's Name*

Membership Type*

How did you find us?

Medical Questionnaire

For most people, physical activity should not pose any problems or hazard. This medical questionnaire aims to identify any problems that might make it inappropriate for someone involve themselves in some Mad Swans fitness classes.

If the answer to any of the following questions is YES, please provide details under the question. If NO, feel free to leave blank.

Has your doctor ever informed you that you have a problem or condition with your heart?

Have any members of your immediate family suffered from any heart conditions?

Have you ever had pains in your heart or chest? If so, what and how often?

Do you ever experience spells of severe dizziness? If so, when and how often?

Have you ever been informed by your doctor that your blood pressure is too high?

Do you currently have any symptoms from a previous back injury or do you experience back pain as a result of physical activity?

Do you have any current muscle or joint injuries that could be worsened by a change in your physical activity?

Are you currently under any form of medication? If yes, please give details.

Do you have any other reasons/symptoms that could cause you to be concerned about a change in your physical activity? (e.g. asthma, diabetes, osteoporosis). If so, please give details.

Are you pregnant or have you been pregnant in the last 6 months? If so, have you discussed being active with your antenatal nurse?

Goals

What are you looking to achieve from joining the gym? (i.e. tone up, improve fitness, lose weight, improve health, etc.)

How many times a week do you plan to attend the gym or exercise classes?

How long will you typically spend in the gym of a visit? (i.e. 45 mins, 60 mins, etc.)

Would you consider your diet to be healthy?

Would you be interested in receiving guidance with your nutrition?

Declaration

It is your responsibility to inform us of any changes to the information held by us in connection with this form so that we can keep our records up to date. The information on this form will be held under EU General Data Protection Regulation (GDPR) and will be used by Mad Swans for purposes associated with your membership only. No personal information will be disclosed to any third parties without your consent.

From time to time, you agree to receive information by email regarding upcoming promotions and events at Mad Swans.

* I have read and fully understand the terms and conditions of the membership. I acknowledge that cancellation of my direct debit requires a minimum of 4 weeks written notice ad payments due in the notice period must be made. Failure to abide by these terms and conditions will result in debt collection action being taken against me.