Email Address:(required) Password:(required) Confirm Password:(required) First Name:(required) Last Name:(required) Date of Birth:(required) Gender:(required) Female Male Phone Number:(required) Address Line 1:(required) Address Line 2: Suburb:(required) State:(required) NSW QLD SA TAS VIC WA Postcode:(required) Goal Weight:(required) Weekly Exercise Goal:(required) Emergency Contact Name:(required) Emergency Contact Phone Number:(required) Do you have any medical conditions?(required) Do you have any pain or injuries?(required) Were you referred by someone? If so what is their name?:

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By clicking “Register and Pay”, I acknowledge that there is a 48 hour cooling off period from the time of registration. Cancellation will incur a 20% penalty of the total proposed payment(s). After this period, I acknowledge that the remaining payments will be deducted until the registration end date. Any bank charges will automatically be charged by the Ezidebit payment system and are not included in the prices listed above. I also acknowledge and accept the BodySwitch Challenge Terms Of Participation in full.
(Link to Terms of Participation – http://bodyswitch.com.au/terms-of-participation/)