Registration form Subscription / Fitness Customer Gender male female Title First name Surname Date of birth Street, no. Postcode Location Telephone number E-mail Legal representative (in the case of people under the age of 18) Background information regarding registration Background Previous therapy Fitness Performance optimisation Desired appointment Day Monday Tuesday Wednesday Thursday Friday Time Morning Noon Afternoon Only out of hours (7 a.m - 9 a.m. / 6 p.m. - 8 p.m.) Notes regarding desired appointment I have read and agree with the data privacy statement. Leave this field blank