Classic form

Gym membership form

Everything a gym needs to sign somebody up in one sitting, including the health screening and the waiver signature that usually sends people back to paper.

Make one like this15 fields, 9 required

Welcome screen of the gym membership form example — The welcome screen respondents see first. The image was generated for this example.

The form itself

A static copy of the finished form, exactly as it renders. Nothing here can be filled in or submitted, so read it as a reference and build your own from the button above.

Ironbark Fitness membership

Everything we need to get you training, including the standard health screening. It takes about five minutes and you can start the same day.

About you

Full name *

First

Last

Date of birth *

Mobile number *

Email address *

Home address

Street address

Unit or apartment

Suburb

State

Postcode

Emergency contact

Contact name *

Relationship to you

Contact phone *

Your membership

Membership plan *

Full access, $24.90 per week

Off peak, weekdays before 4pm, $18.90 per week

Classes only, $16.90 per week

12 month paid upfront, $999

Preferred start date *

How would you like to pay?

Direct debit from a bank account

Recurring card payment

Paid upfront

What are you training for?

General fitness

Strength

Weight loss

Sport specific

Rehabilitation

Something else

Health screening

These are the seven standard PAR-Q questions. Answering yes to any of them does not stop you joining. It just means we ask you to check with your doctor first, and we build your program around it.

Physical Activity Readiness Questionnaire

	Yes	No
Has your doctor ever said that you have a heart condition, or that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness, or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs for your blood pressure or a heart condition?
Do you know of any other reason why you should not do physical activity?

If you answered yes to any of the above, tell us more

Waiver and signature

I confirm the information above is true and complete. I understand that physical exercise carries risk, that I take part at my own risk, and that I will tell Ironbark Fitness if my health changes. I have read the membership terms and the cancellation policy.

Signed *

Signature is required

Every field, and what it collects

The complete field list, in the order respondents meet it.

Full nameNameRequired
Date of birthDateRequired
Mobile numberShort textRequired
Email addressShort textRequired
Home addressAddress
Contact nameShort textRequired
Relationship to youShort text
Contact phoneShort textRequired
Membership planSingle choiceRequired: Options: Full access, $24.90 per week · Off peak, weekdays before 4pm, $18.90 per week · Classes only, $16.90 per week · 12 month paid upfront, $999
Preferred start dateDateRequired
How would you like to pay?Single choice: Options: Direct debit from a bank account · Recurring card payment · Paid upfront
What are you training for?Multiple choice: Options: General fitness · Strength · Weight loss · Sport specific · Rehabilitation · Something else
Physical Activity Readiness QuestionnaireRating grid: Statements:
Has your doctor ever said that you have a heart condition, or that you should only do physical activity recommended by a doctor?
Do you feel pain in your chest when you do physical activity?
In the past month, have you had chest pain when you were not doing physical activity?
Do you lose your balance because of dizziness, or do you ever lose consciousness?
Do you have a bone or joint problem that could be made worse by a change in your physical activity?
Is your doctor currently prescribing drugs for your blood pressure or a heart condition?
Do you know of any other reason why you should not do physical activity?
If you answered yes to any of the above, tell us moreLong text
SignedSignatureRequired

What makes this form work

The PAR-Q is a grid, not seven questions

Seven separate yes or no questions feel like an interrogation. The same seven as a single grid read as one quick pass, and the answers come back in the same shape every time.

The screening explains itself first

A line above the grid says that answering yes does not stop you joining. Without it, people under-report, which is exactly what a health screen must not cause.

The waiver is signed on the spot

An inline signature means the member is signed up before they leave the counter. No printing, no scanning, no chasing a signature that never comes back.

Questions people ask

What is the PAR-Q?

The Physical Activity Readiness Questionnaire, the industry standard health screen. It is seven yes or no questions about heart conditions, chest pain, dizziness, joint problems and blood pressure medication.

Does answering yes to a PAR-Q question stop someone joining?

No. It means the gym asks them to check with their doctor first and builds the program around it. Saying so on the form matters, because otherwise people answer no to avoid the hassle.

Is a signature on a web form enough for a waiver?

An inline signature is drawn or typed by the member and stored with their response, with the date recorded. For a countersigned agreement, use the e-signature flow instead so each signer gets their own emailed link.

Build your own in about a minute

The button below opens the form generator with this use case already described. Change the wording to match your own, generate, then edit anything you like.

Make my gym membership form