REGISTRATION

REGISTER TODAY

IN LINE WITH GDPR REGULATIONS, REGISTRATION IS ESSENTIAL IN ORDER FOR US TO HAVE YOUR CONSENT FOR FIZA CLUB TO STORE, PROCESS AND USE YOUR PERSONAL INFORMATION.

If one does not register, FIZA CLUB will be unable to contact them with their health plan/ recommended remedies and where applicable, unable to post any remedies out to them.

PLEASE FILL IN ONE FORM FOR REGISTRATION PER PERSON

(I.E. IF APPLYING FOR BOTH YOURSELF AND YOUR CHILD, FILL IN ONE FORM FOR YOUR CHILD AND A SEPARATE ONE FOR YOURSELF).

By filling in this form below you are consenting for the data filled in below to be collected and securely stored by FIZA CLUB. (see our Ts & Cs and Privacy Policy).

Please ensure the data filled in is complete and accurate at the time of filling the form.

If you have questions, concerns or issues over filling out parts of the form, please refer to the FAQ's on FIZA CLUB's website or contact us via email.

Please ALSO ENSURE to pay your Registration fees(£17.50) below.

We can ONLY process your application for registration ONCE this payment has been received.

REGISTRATION FORM

BY FILLING AND SUBMITTING THIS FORM YOU ARE HEREBY GIVING YOUR CONSENT FOR FIZA CLUB TO HOLD, PROCESS AND SECURELY STORE YOUR PERSONAL (AND WHERE APPLICABLE YOUR CHILD'S PERSONAL) IDENTIFIABLE INFORMATION, WHICH YOU HAVE DISCLOSED HEREIN; WHICH IS CORRECT TO YOUR BEST KNOWLEDGE AT THE TIME OF FILLING THIS FORM. AS WELL AS CONSENT FOR FIZA CLUB AND ITS PRACTITIONER(S) TO HOLD, PROCESS AND SECURELY STORE ANY: CASE NOTES, REPORTS, LAB REPORTS AND THERAPEUTIC PLANS NEEDED IN ORDER FOR US TO SUPPORT YOUR WELLNESS JOURNEY.

* Indicates required field

Name *

First

Last

Email *

Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

IF APPLYING FOR A CHILD ENTER CHILD'S NAME *

First

Last

BY FILLING AND SUBMITTING THIS FORM YOU ARE CONSENTING THAT YOU HAVE READ AND AGREE TO FIZA CLUB'S TERMS & CONDITIONS AND PRIVACY POLICY

Submit

REGISTRATION FEES

REGISTRATION FEE - £17.50 NON REFUNDABLE

EACH SEPARATE REGISTRATION REQUIRES A SEPARATE REGISTRATION FEES

N.B.
The Registration payment is your confirmation for the consent herein and is regarded as "the signing of this contract" between yourself and FIZA CLUB, thereby giving your permission to FIZA CLUB to:" hold, process, use and store your personal information.

REGISTRATION FEES

Please note, this button goes to our external square payment page

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REGISTer

REGISTER TODAY

REGISTRATION FORM

REGISTRATION FEES