The Body Healthcare - Membership Checkout

Membership Information

You have selected the GENERAL MEMBER - 1 Year membership level.

Membership For One Year, Auto Renew Membership After One Year @ $105.00

The price for membership is $105.00 now.

Membership expires after 1 Year.

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Account Information

Username

Password

Confirm Password

Hint: The password should be at least twelve characters long. To make it stronger, use upper and lower case letters, numbers, and symbols like ! " ? $ % ^ & ).

First Name

Last Name

Email Address

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Full Name LEAVE THIS BLANK

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Personal Details

Date Of Birth

Phone Number

Make sure you put a number here as its used on profile page

Address 1

Address 2

City

Province/State

Postal Code/Zip Code

Country

Home Phone Number

Cell Phone Number

Applicants Under The Age Of 18

Require parental or legal guardian consent for members applications

Parent Or Guardian Full Name

By electronically signing your name above, you assume complete responsibility for the child mentioned above.

Provider-Facility Name

Name Of Your Provider Or Facility You Attend

Agreement The Body Membership Agreement

The Body Membership Agreement Form must be thoroughly reviewed and accepted prior to submitting your Members Form, along with your electronic signature for our disclosure.

The Body Membership Agreement

Please click link to open document and read this Agreement. By clicking in the checkbox, you agree to everything on the Body Membership Agreement

Agreement The Body Arbitration

The Body Arbitration Form must be thoroughly reviewed and accepted prior to submitting your Members Form, along with your electronic signature for our disclosure.

The Body Arbitration

Please click link to open document and read this Agreement. By clicking in the checkbox, you agree to everything on the The Body Arbitration

By Electronically Signing This Form Below

You confirm that you have read the "Body Membership Agreement" and "The Body Arbitration" forms provided above. Additionally, you consent to being added to our email list, allowing us to contact you concerning your membership and to send you our newsletters.

Your Full Name

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