Upfront Payment Memberships | Mick's Gym 24/7 Melton

To purchase a once-off or ongoing upfront membership option, please fill in the following form and then progress to our secure online payment facility. You will be able to pay with your Visa, MasterCard or American Express.

Name*
First Last
Email Address*
Emergency Contact Number*
Your Date of Birth*
DD slash MM slash YYYY
Upload Your Photograph*
Must be your headshot.
Accepted file types: jpg, gif, png, pdf, Max. file size: 5 MB.
Signature*
Please sign your signature in the panel below.
Other Questions
Do you have any questions in relation to your online membership signup? If so please include them here.
Terms & Conditions*
- Please confirm you've read the Terms & Conditions