Leisure Centre Registration Form

Leisure Centre Name
Required
Full Address:
Required
Town/City: Required Post Code:
Required
Telephone:
Required
Fax:
Required
Email:
Required
Please enter a valid email
Website:
Date Commenced Trading: Required

Facilities Check List

Parking Bar Disabled Access Cardio Machines Free Weights Swimming Pool Spa Sauna
Steam Room Treatment Room Fitness Classes Personal Training Sports Halls Locker Rooms Other
Other (specify):
Special Instructions:
Where would you like your screen installed?
Estimated Annual Footfall:
Contact Name:
Required		 Position:
Required
I agree to the terms and conditions and am duly authorised to sign for the grantor:
Date:
Day
Required		 Month
Required		 Year
Required