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Your Personal Details

Club

First Name

Last Name

Date of Birth

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Female

Password

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Street

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How did you hear about us?

Occupation

Name

Phone

Relationship

Behavioural Information

Start Date

First Payment Date

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Membership

Fire Service

Description

This is a free gym membership for Volunteer Fire Fighters from Kumeu Fire. We will verify your details with Alice Rose at Kumeu Fire.

Price

$0.00 Yearly in Person

Promotion

$0.00 until

Account Credit

applied after signup

Membership Start Date

First Payment Date

Prorated Upfront Fee

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