FITNESSfive42™ - Online Registration
FITNESSfive42™ - With you every step of the way...!
Welcome to FITNESSfive42 Online Registration
By Selecting "YES" I (We) confirm that I (We) have read, understand and concur with the F542 "WAIVER" (available in menu at left)
YES
Please select your Program:
20 Week Full Marathon Training program $99.99+HST
Fall 10k Training program $59.99+HST
Enter your FITNESSfive42 Discount Code (discount applied at time of processing)
1. Participant Information:
First Name:
Last Name:
Date of Birth: (dd/mm/yyyy)
Gender:
Female
Male
Address:
City:
Postal Code: (A1A 1A1)
Daytime phone:
Evening phone:
Email Address:
Are you registering as a couple?
No
Yes (If yes: please complete Section 2)
2. Second Person's Information:
First Name:
Last Name:
Date of Birth: (dd/mm/yyyy)
If under 18; name of accompanying adult: (First & Last Name)
Gender:
Female
Male
Address:
City:
Postal Code: (A1A 1A1)
Daytime phone:
Evening phone:
Email Address:
Credit Card & Payment Information
Please select Credit Card Type:
VISA
Mastercard
Email Money Transfer (EMT)**
Credit Card Number: (no spaces)
Card Expiry Date: (mm/yyyy)
Three Digit Security code: (CSC Number on back of card)
Name on Card: (exactly as printed on credit card)
Please Note: All Credit Card Transactions will appear as "Nossa-F542" in your Credit card Statement.
__________
** For Email Money Transfers (EMT) Please forward full payment (including 15% HST) via email to: Registration@fitness542.com
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Please submit questions and/or requests for additional information below. At FITNESSfive42 it is "All about You" (and You and You...) As such, FITNESSfive42 will endeavour to reply with 48 hours.
Question(s):
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Thank you for your registration. We look forward to running and training with you!
**Please note your credit card payments will be processed within 48 hours of your program's start date. A transaction receipt will be issued and sent to the email address provided at time of registration.