Application Form

Love It Fitness Membership Application

INFORMED CONSENT AND HEALTH DECLARATION
I am aware that participating in a fitness program poses some risk and I know of no physical or other reason why I should not participate.
This will acknowledge that neither the Instructor nor Zumba Fitness LLC is responsible for any injury I might sustain.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Questions or health issues you wish to discuss? *

Flex Pass - Zoom & ZIN Studio Classes *

10 classes $80

Unlimited Monthly Pass *

1 Month $80

Live Class Registration *

No live classes available at this time

Preliminary Covid-19 Screening (Live Classes) *

I am not unwell and have no symptoms I have not travelled I have not been exposed to anyone who has tested positive for covid-19 I have not been advised to remain in quarantine I have been fully vaccinated

Payment may be made via etransfer to spomfret@live.ca

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