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App Form

The document is an application form for membership to the Arjun Fitness Club. It requests information such as name, address, date of birth, occupation, and preferred activities. It requires a medical certificate confirming the applicant's fitness for exercise activities. It outlines general rules including that membership fees are non-refundable, entry to the pool requires a swimsuit, and children under 5 are prohibited. The form is to be submitted within 15 days along with payment of a 100 rupee application fee.

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Ankit Wankhede
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50 views3 pages

App Form

The document is an application form for membership to the Arjun Fitness Club. It requests information such as name, address, date of birth, occupation, and preferred activities. It requires a medical certificate confirming the applicant's fitness for exercise activities. It outlines general rules including that membership fees are non-refundable, entry to the pool requires a swimsuit, and children under 5 are prohibited. The form is to be submitted within 15 days along with payment of a 100 rupee application fee.

Uploaded by

Ankit Wankhede
Copyright
© Attribution Non-Commercial (BY-NC)
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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APPLICATION FORM

ARJUN FITNESS CLUB


Form No.

E-5, Bittan Market, Arera colony, Bhopal-462016, Tel. 420513


(Application form shall be submitted within 15 days from the date of issue)
Receipt No.
Date

Form fee Rs. 100/


Sig. Account Clerk
Event
Photo

Preferred Time slot

Swimming
Squash
Fitnees Cell
* Gym

* Fitness

* Aerobic

*Yoga

Name _____________________________ Surname _____________________________________


Father / Husband / Guardian Name _____________________________________________________
Address__________________________________________________________________________
Date of Birth______________________ Age ______________ Sex : F

Phone: Resi. _________________________________off. ___________________________________


Occupation _______________________________________________________________________
Activity- Individual, Family (Swimming / Squash / Fitness)

Signature of Applicant

MEDICAL CERTIFICATE
It is to certify that Mr. / Ms.__________________________________________________________
is medically examined by me. He/She is no suffering from any catagious decease or epilepsy. He/She is fit
for above activity

Blood Group

Signature, Seal with Registration no. of


Authorised Medical Officer

GENERAL RULES & REGULATION


* RIGHT OF ADMISSION RESERVED.
* MEMBERSHIP FEES NON-REFUNDABLE / NON TRANSFERABLE.
* MEMBERS ARE ADVISED NOT TO BRING ANY VALUABLES. THE MANAGING
* COMMITTEE SHALL NOT BE RESPONSIBLE FOR ANY THEFT / LOSS.
* ENTRY ISIDE THE POOL IS PERMITTED ONLY WITH SWIMMING COSTUMES
AND AFTER A SHOWER.
* MANAGING COMMITTEE RESERVES THE RIGHT TO CANCEL ANY MEMBER
SHIP IF SO WARRANTED.
* VISITORA ARE NOT ALLOWED.
* MEMBERS ARE REQUESTED TO CO-OPERATE WITH MANAGEMENT FOR BET
TER SERVICES.
* MANAGEMENT SHALL NOT BE RESPONSIBLE FOR ANY ACCICENT INJURY, L
LOSS OF LIFE CAUSED IN THE PREMISES OF FITNESS CLUB.
* THE FITNESS CENTRE SHALL BE FUNCTIONAL AS PER SPECIFIED CLENDER.
CHILDREN BELOW 5 YEARS ARE STRICTLY PROHIBITED.

I hereby declare that I have read the rules & regulation of the Arjun fitness Club and do swear that I/ my
family will abide by them.
Signature of applicant

FOR OFFICE USE ONLY


Recd. Rs._____________________(in words) __________________________________________
ON ACCOUNT OF MEMBERSHIP FEES+OTHER CHARGES.
Receipt No. __________________________________Date ___________________
Time slot allotted

Singanature of Account clerk

APPLICATION FORM

ARJUN FITNESS CLUB


E-5, Bittan Market, Arera colony, Bhopal-462016, Tel. 420513

Name

Age

1) _________________________

Relation

__________
Blood Group

2) _________________________

Photo

__________

Blood Group

3) _________________________

Photo

Photo

__________

Blood Group

Photo

MEDICAL CERTIFICATE
It is to certify that Mr. / Ms.__________________________________________________________
Mr./Ms__________________________________________________________________________
Mr./Ms __________________________________________________________________________
are medically examined by me. They are not suffering from any catagious decease or epilepsy. They are fit
for above activity
Signature, Seal with Registration No. of
Authorised Medical Officer

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