Planet Fitness Online Application Form – Fill Out and Use This PDF

Universal 360°, a division of Universal Healthcare Services (Pty) Ltd,

Registraion no 2008/005871/07

Universal House, 15 Tambach Road,

Sunninghill Park, Sandton, 2191

PO Box 1411, Rivonia, 2128

Telephone: +27 86 155 5483

Facsimile: 086 504 1545

E-mail: 360@universal.co.za

www.universal360.co.za

PLANET FITNESS APPLICATION FORM 2013

Access Planet Fitness through Universal 360°

Being it means being healthy, strong and toned. Increased health awareness has shown us that a consistent itness regime is key to balance and wellness, and if that is what you’re aiming for then Planet Fitness is part of the plan. Plus, if you are a Universal 360° member it’s easier AND cheaper. What more is there to say?

Do I qualify?

Yes, yes and yes again! Everyone has the right to get it.

What does it cost?

Well first of all, as a Universal 360° member your activation fee will be waived. Thereafter there is a once-off tag fee of R100 and a monthly debit order at a discounted rate in accordance with the option you choose. You can check the price structure on the following pages.

Where do I sign up?

Please see the instrucions and applicaion form below.

HOW TO ACTIvATE YOUR PLANET FITNESS

MEMBERSHIP THROUgH UNIvERSAL 360°

Universal 360° Alpha members

Step 1: Acivate your Universal 360° Alpha beneit

•Acivate your 360° Alpha membership by calling 086 155 LIVE (5483) and compleing the applicaion form. You can also access the 360° Alpha applicaion form at www.universal360@universal.co.za.

•You have one month from the ime you become a Planet Fitness member to acivate your 360° Alpha membership for access to the discounted rates.

•If you don’t sign up during this month you will be billed the standard Planet Fitness rate for the duraion of your contract.

Step 2: Go to Planet Fitness and sign the form

•Read, complete and sign the applicaion form.

•Provide the consultant with your Universal 360° Alpha membership number and idenity document.

Step 3: Pay the tag fee and irst month’s gym fees to the Club

•Pay the R100 tag fee at the Planet Fitness facility either by cash or credit card.

•Pay the irst month’s membership fee to the Club either by cash or credit card.

•Hand in your signed applicaion form and debit order form to a consultant at your selected Planet Fitness club.

Step 4: Get your body moving

•You will be given a Planet Fitness access tag and have immediate access to the Planet Fitness facility.

•A itness consultant from Planet Fitness will contact you to help you get started with your exercise programme.

Universal 360° Beta members

Step 1:

•Note: This basic Universal 360° opion is available to all principal members of medical aid schemes administered by Universal Healthcare Administrators, employees of employer groups contracted with Universal WorkerPlan as well as VIP stakeholders such as Universal Network healthcare service providers and brokers contracted with the Universal Group and its clients. As a VIP stakeholder you need to acivate your 360° Beta membership by compleing the acivaion form. You can access the 360° Beta acivaion form at www.universal360@universal.co.za or call 086 155 LIVE (5483).

•You have one month from the ime you become a Planet Fitness member to acivate your 360° Beta membership for access to the discounted rates.

•If you don’t sign up during this month you will be billed the standard Planet Fitness rate for the duraion of your contract.

Step 2: Go to Planet Fitness and sign the form

•Read, complete and sign the applicaion form.

•Provide the consultant with your Universal 360° Beta membership number and idenity document.

Step 3: Pay the tag fee and irst month’s gym fees to the Club

•Pay the R100 tag fee at the Planet Fitness facility either by cash or credit card.

•Pay the irst month’s membership fee to the Club either by cash or credit card.

•Hand in your signed applicaion form and debit order form to a consultant at your selected Planet Fitness club.

Step 4: Get your body moving

•You will be given a Planet Fitness access tag and have immediate access to the Planet Fitness facility.

•A itness consultant from Planet Fitness will contact you to help you get started with your exercise programme.

Please note

You will have access for as long as you remain a valid member of Universal 360° and as long as Planet Fitness remains a Universal 360° partner. You cannot transfer your rights herein. Under no circumstances are any fees refundable. This beneit is subject to the rules of Universal 360°.