PAXLAN ‘DOING IT TOUGH PROGRAM’

ARE YOU, OR SOMEONE YOU KNOW DOING IT TOUGH?

At PAXLAN Fitness, we believe that everyone deserves the chance to be part of our amazing gym family, especially during tough times.

Name

First Name

Last Name

Phone

(###)

###

####

Are you applying for yourself or nominating someone else?

If nominating someone else:

First Name

Last Name

Phone

(###)

###

####

Address

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Which type of membership are you interested in?

What are your preferred times for attending the gym/classes?

Briefly describe your current financial situation and why you/your nominee would benefit from this membership:

How long have you/your nominee been facing these financial challenges?

Are there any specific fitness goals you/your nominee have?

How motivated are you/your nominee to commit to a regular fitness routine at PAXLAN Fitness?

Why do you/your nominee want to be part of the PAXLAN Fitness family?

Do you/your nominee have any existing health conditions or injuries that we should be aware of?

If yes, please provide details:

I agree to the terms and conditions of the PAXLAN Fitness Promo Offer for "Doing It Tough Program".

I consent to PAXLAN Fitness using the information provided in this application for the purpose of evaluating eligibility for the program.

We understand that discussing financial challenges can be difficult. Please be assured that all information provided will be kept confidential and used solely for the purpose of evaluating eligibility for the PAXLAN Fitness Promo Offer for 'Doing It Tough Program' By clicking submit, I acknowledge my agreement to abide by the terms and conditions of the PAXLAN FITNESS "Doing It Tough Program".

Terms and Conditions

PAXLAN ‘DOING IT TOUGH PROGRAM’

ARE YOU, OR SOMEONE YOU KNOW DOING IT TOUGH?

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