MEMBER INTAKE/RENEWAL FORM
Thank you so much for your patience and understanding as we navigate the current situation and as we begin our slow re-open process. Please note: we are not yet allowed to activate our 24 hour door.
Email address *
First and Last Name *
Phone Number *
Billing Address (please include street, unit number, city, province/state, and postal code/zip) *
Are you re-starting your currently paused membership due to COVID OR purchasing a new membership?
What day would you like it to restart or activate? *
MM
/
DD
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YYYY
If you're simply re-starting an existing membership, please disregard the next section and click submit down below.
If purchasing new, please indicate what type of gym membership you would like (price does not include tax):
Clear selection
Credit Card Number
Expiration Date
CVV Security Code (3 digit code on back of card)
Authorization
I understand that by submitting this form, I authorize PURE Gym & Juicery (1081310 BC LTd.) to charge my credit card with the above information.
Any additional comments or concerns? Please let us know.
READY? Let's do this!!
Click submit and let's get started!
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