Welcome To World Gym Dartmouth - Online Member Sign Up

Selected Home Club: Dartmouth [Club Details]


Membership Includes:
� ALL BASIC Membership Amenities
� Unlimited Group X Classes
� FREE Childminding ( 2 children per VIP member)*
� FREE Guest every 24 hours (one person per visit)**
� Unlimited Tanning
� Unlimited Hydro Massage
� 50% off Smoothies Every Wed

*Extra Child $10
**Free Guest has 3 Days Limit

Additional Information:
� One Time Enrollment Fee - $29.99
� One Time Card Fee - $20
� Maintenance Fee ($25 billed twice per year on the 15th of August & February)
� Billed Bi-Weekly to a Credit Card, or Chequing Account
� 12 Month Minimum Term
� All Prices Plus Tax

Initial Payment
Card Fee
Enrollment Fee
Prorated Bi-Weekly Due
Amount due now:

Payments Starting on 13-Dec-19
Bi-Weekly Due
Please complete all of the following fields. You only need to enter 1 telephone contact; when entering a telephone number please enter all 10 digits without any spaces; when entering the postal code please enter all 6 characters without any spaces.
First Name   Last Name   Gender   Date of Birth
    Male Female  
Street Address   Province/State   City   Postal/ZIP   Email (Username)
Home Tel.   Mobile   Emergency Contact   Emergency Tel.   Referral Source

Card Type   Card Number  
Expiry Date   Cardholder Name   CSV [?]
Use address above for billing information
Street Address   Province/State
City   Postal/ZIP
Use same information as initial payment
Card Type   Card Number  
Expiry Date   Cardholder Name   CSV [?]
Use address above for billing information
Street Address   Province/State
City   Postal/ZIP

Before finalizing your purchase, please carefully read the following terms and conditions.
Electronic Signature

I understand that my electronic signature below constitutes a legal signature confirming acceptance of the membership agreement.

I understand that I must make at least 26 bi-weekly payments before I can cancel my membership with a thirty (30) day written notice.

I understand that I must come into the gym and fill out a written thirty (30) day cancellation notice form in order to cancel my membership, once my initial 12 month term is complete. I agree to pay one additional month from the date of my cancellation. I understand I cannot cancel by phone, email or by informing a staff member verbally.

Transactional Information:

World Gym recommends that all membership bill payments be processed electronically. If payment must be made on site, such payment must be made no later than 4 days before payment due date. Any account changes must also be made no later than 4 days before the payment due date.

The Maintenance fee is an industry standard fee used to enhance our facilities, services, and programs for our members. We plan for continuous improvements and upgrades to our location and expanding our location base in the years to come. Please note that the maintenance fee of $25.00 will be applied to all active, non-pre-paid, members on the 15th of August and February. If you are no longer an active member at this time, no fee will be applied.

World Gym requests members to use their World Gym Online Fitness account to manage any past due payments. World Gym will access a $35 Non-Payment fee for all rejected credit card and/or bank account debits. Credit card and bank account changes are the sole responsibility of the member. I understand that I must notify the gym for any account information changes including: Bank issued credit cards/access cards, lost or stolen credit cards/access cards, and any expiration date change.

Buyer acknowledges receipt of a fully completed copy of this contract and acknowledges all terms and conditions set forth on this contract. I authorize World Gym to debit my credit card or bank account on a bi-weekly basis, for all current balances and every 7 days for past due balances. I agree to pay all maintenance fees, late fees, one additional month due upon cancellation and any damage I or my guests may cause to the gym.

Please sign below