LIFT FITNESS | Online Membership Application

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Thank you for registering with Energym FIT

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Your membership request has been submitted successfully. Our team will contact you shortly to confirm your preferred start date and complete the onboarding.

Please keep your phone available. If you made a mistake, you can submit again using “Start Over”.

Membership Application

Please complete all required fields carefully. Fields marked with are mandatory.

Location Select the gym location to load its membership application.

Personal details

First Name

Middle Name

Last Name

Date of Birth

Format: YYYY-MM-DD

Age

Automatically calculated

NIC / Passport

Enter Valid NIC or Passport

Gender

Select Gender

Weight (kg)

Height (cm)

Health information

Do you have any medical conditions?

Yes No

If yes, please specify

Are you currently taking any medications?

Yes No

If yes, please specify

Do you have any allergies?

Yes No

If yes, please specify

Have you been advised by a physician not to engage in physical activity?

Yes No

Other medical reasons (if any)

Medical information (PAR-Q)

Please read each question carefully and answer honestly by ticking YES or NO.

If you answered YES to one or more questions, you should consult with your doctor to clarify that it’s safe for you to become physically active at the current time.

Default is NO for all questions (you can change any).

Has your doctor ever said you have a heart condition and that you should only do physical activity recommended by a doctor?

Yes No

Do you feel pain in your chest when you do physical activity?

Yes No

In the past month, have you had a chest pain when you were not doing physical activity?

Yes No

Do you lose balance because of dizziness or do you ever lose consciousness?

Yes No

Do you have a bone or joint problem (for example back, knee or hip) that could be made worse by a change in your physical activity?

Yes No

Is your doctor currently prescribing medication for your blood pressure or heart condition?

Yes No

Do you know of any other reason why you should not take part in physical activity?

Yes No

If YES, please comment

Contact & emergency details

Mobile No

Sri Lankan mobile — 07X

WhatsApp No

Auto-fills from Mobile (you can change if different)

Email

Address

Emergency Name

Emergency Contact No

Membership & payment

Preferred Start Date

Registration Fee

Package

Expire Date

Calculated from Preferred Start Date and the selected package duration.

Package Amount

Auto from selected package.

Remarks

Total

Payment Type

Member photo

Preview

Example of a correct member face photo

Correct photo example

• Face the camera directly

• Centre the full face

• Use bright, even lighting

• Remove hats, masks and sunglasses

Required: Upload or capture a clear face photo (front view).

If camera is blocked, use this upload option.

Photo required. Please upload/capture a clear face photo.

A quick question

We’d love to know—where did you first hear about us? Select one option

Instagram Facebook TikTok Google Search Our Website Referred by a Friend Other

Terms & Conditions of Membership

Membership fees are non-refundable unless stated otherwise by management.
Members must follow club rules and staff instructions for safety.
Misuse of equipment or misconduct may result in suspension.
Personal belongings are the member’s responsibility.

I have read and agree to the above Terms & Conditions.

You must agree to the Terms & Conditions to proceed.

Digital Signature (Required)

Please sign using your finger / mouse. (Required)

Clear & Start Over

ⓘ After you submit, our team will review your details and contact you to finalise your membership.