Gym Membership RegistrationUse the Form Below to Register Your Month to Month Membership. "*" indicates required fields Membership Registration* Month to Month - Price: $70/Non-Recurring Name* First Last Phone*Email* Address Street Address City AlbertaBritish ColumbiaManitobaNew BrunswickNewfoundland and LabradorNorthwest TerritoriesNova ScotiaNunavutOntarioPrince Edward IslandQuebecSaskatchewanYukon Province Postal Code Date of birth* MM slash DD slash YYYY Consent* I have read and I agree to the Wilkie Wellness Terms & Conditions Waiver* I have read and I agree to the Wilkie Wellness Gym Waiver GST - 5% Price: $ 0.00 CAD Total Securely pay with your credit card using SquareTMCredit Card* Cardholder Name Card Details CAPTCHA
