New Customer Signup - British Barbell

1x / week Development

Membership details:

Ongoing membership
Paid on the 2nd each month
£4.52 pro-rata payment for January
£35.00/month from February

Full Name

Email address

Phone number

Date of birth

Gender

Address Line 1

Address Line 2

City

Region

Postcode

Country

Medical/Injury Details

Emergency contact

Full name

Phone number

Legal Documents

British Barbell - BRITISH BARBELL COMMUNITY AMATEUR SPORTS CLUB PHYSICAL ACTIVITY READINESS QUESTIONNAIRE (PAR-Q)

We are very pleased to welcome you to British Barbell.

If you are under 18 please also ask your parents/carer to complete the form before it is returned.

Your personal information will be held and used in accordance with GDPR regulations.
Here at British Barbell we take your privacy seriously and only use your personal information to administer your membership.

Please delay exercise if;
● You are not feeling well because of a temporary illness such as a cold or fever - wait until you feel better
● If you are or may be pregnant, talk with your doctor before you start becoming more active.
● Please consult a Doctor if you develop a condition that may be aggravated by exercise
Please delay exercise if;
● You are not feeling well because of a temporary illness such as a cold or fever - wait until you feel better
● If you are or may be pregnant, talk with your doctor before you start becoming more active.
● Please consult a Doctor if you develop a condition that may be aggravated by exercise

Scroll to view entire agreement

Has your doctor ever said that you have a heart condition OR high blood pressure?

Yes

Do you feel pain in your chest at rest, during your daily activities of living, OR when you do physical activity?

Yes

Do you lose balance because of dizziness OR have you lost consciousness in the last 12 months?

Yes

Have you ever been diagnosed with another chronic medical condition (other than heart disease or high blood pressure)?

Yes

Are you currently taking prescribed medications for a medical condition?

Yes

Do you have a bone or joint problem that could be made worse by becoming more physically active?

Yes

Has your doctor ever said that you should only do medically supervised physical activity?

Yes

The Equality Act 2010 defines disability as a physical or mental impairment with a substantial, long-term impact on daily activities. Do you feel you meet this definition?

Yes

If you checked YES to any of the above, please provide details by email to britishbarbell@gmail.com

I confirm that the information given is a true and accurate statement. I understand that if I have declared any of the conditions listed, further information may be requested. Please be aware that it is your responsibility to inform us if there is a change to any of your answers on the PAR-Q.

Start Date

When would you like your membership to start?

Today

A different date

Payment Details

Please enter your payment details below:

X Amex not accepted

All Options
1x / week Development	£35.00/month
2x / week Development	£45.00/month
Kickstarter	£45.00
Program Only	£35.00/month
Unlimited Powerlifting	£110.00/month