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Membership
Details
Terms & Conditions
Payment
Confirmation
Your Personal Details
Club
Prime Performance
First Name
Last Name
Date of Birth
Gender
Male
Female
Email
Password
Confirm Password
Cell Phone
Home Phone
Work Phone
Street
Suburb
City
State
Postal Code
Country
New Zealand
How did you hear about us?
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Google
Social Media
Walked by
Word of mouth
Occupation
Emergency Contact
Name
Phone
Relationship
Behavioral Information
House Number
Parent Full Name if under 18 or n/a
Parent Phone Number if under 18 or n/a
Parent Email address in under 18 or n/a
Start Date
First Payment Date
promo_impact_start_date
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Membership
LONGEVITY
Description
Minimum Term: 6 Month Contract
Price
$100.00 Weekly by Billing
Signup Fee
$35.00
Promotion
$0.00 until
Account Credit
applied after sign-up
Membership Start Date
Minimum Term
6 months
First Payment Date
Prorated Upfront Fee
Transaction fees may apply
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