BNB Membership form
All details are required.
Name *
Date of Birth *
Gender *
Postal Address *
Email Address *
Contact number *
Emergency contact's name *
Emergency contact's number *
Name of bank *
Bank account holder's name *
BSB Number *
Account Number *
Debit frequency (I suggest choosing the same frequency that you get paid) *
Day or date for first debit to be taken (I suggest choosing the day of, or the day after your payday) *
I agree & consent to the BNB Gym Rules and BNB Waiver found at the bottom of this page *
Required
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