Forest Mere Health Club Membership - Champneys

Please enclose
two passport
photographs
per person
Application for Membership
Type of membership
c Premier c Single
c Standard Plus c Joint
c Standard
c Country Wide
Please enclose
two passport
photographs
per person
Your details:
Title: Mr./Mrs./Miss.:
First name (s):
Date of birth:
Occupation:
Nationality:
Home address:
If joint, details of second member:
Title: Mr./Mrs./Miss.:
First name (s):
Date of birth:
Occupation:
Nationality:
Home address:
Postcode:
Mobile number:
Telephone number:
Email address:
Postcode:
Mobile number:
Telephone number:
Email address:
Please tick here if you are happy to receive Champneys Promotions & Offers. c
Please note your details will not be passed onto a third party for marketing purposes.
Please indicate where you heard about the Health Club
Entry to the CHAMPNEYS RESORT CLUB will only be permitted after you have received written confirmation
of membership and have been issued a membership number.
To the Champneys Resort Club Committee, I have read the terms and conditions of the Resort Club and
wish to apply for membership.
Signature of Applicant:
Date:
Office Use Only
Date application received:
Joining date:
Membership approved by: c Single c Joint
Type of membership:
Account number:
Renewal Month: c Annual c Direct Debit