LeisureFit Rehab Membership

Fields marked with * are required.

Name

Allied Health Professional

Organisation

First Name

Member Details

Last name

Phone

Address

Phone

Date of Birth

Select your 3 or 6 month Rehab membership

3 Month Healthy Life - $374.00 (full access) 3 Month Healthy Life PLUS - $531.50 (full access including Reformer and Barre classes) 6 Month Healthy Life - $698.00 (full access) 6 Month Healthy Life PLUS - $1013.00 (full access including Reformer and Barre classes)

Select your Rehab Passes

10 x Swim Passes - $70.20 10 x Gym Passes - $166.50 10 x Spa, Sauna, Steam Passes - $121.50 10 x Spa, Sauna, Steam and Swim Passes - $158.40

Please note, pass options are also available in 20 or 40 packs.

If other, please state:

Membership Start Date

Organisation to invoice

Contact Person

Address

Phone

Claim Number

Supporting Documentation

Select a file

Approval document required

Additional Comments

Disclaimer

I declare that my client above is medically and physically fit and free from impairment. I assume with full knowledge the dangers in my client participating in fitness activities and they do so at their own risk.
I am aware the Spa, Sauna, Steam area is not available due to refurbishment works.

I understand and accept the terms and conditions.

Yes, I agree.

Read the Terms and Conditions.

Disclaimer

I want to...

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