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Membership Application

Becoming a Wellness Center Member just got easier. Follow the instructions below and you'll be on your way to better health!

  • Fill out the application below.
  • After you submit your application, print the confirmation screen and bring it with you the first time you visit the Wellness Center.
  • To complete your membership, you will need to fill out a health history survey and receive your membership card.

A membership representative will be in contact with you via email within one business day after receiving your application to answer any questions that you may have. 

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Member Information

*Male or Female:  

Health History

Please indicate if you have been diagnosed or experience any of the following.

*Heart Disease / Hypertension
*Have you ever been diagnosed with any form of cancer?

*Epilepsy or Seizures
COPD, Asthma or Emphysema
*Are you pregnant or post natal?

Diabetes type
Diabetes medications
*Smoking or quit within the last 6 months
*Chest pain within the last month
*Have you lost consciousness or fallen as a result of dizziness?
*Are you under a doctor's supervision for any illness or physical condition that may affect your ability to exercise?
*Do you have muscle/bone/joint problems that are aggravated by exercise?

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Family Members


Type of Membership


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- All membership dues are paid on the 10th of the month or quarter.
- Cancellations require a 30 day notice.

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