Referral Promotion - Gym Services

BCAA PROMOTION

Date*

Member's Full Name*

Phone*

Email*

1) Referral Sign Up - Name*

Phone*

2) Referral Sign Up - Name

Phone

3) Referral Sign Up - Name

Phone

4) Referral Sign Up - Name

Phone

Term and Conditions

I Understand

This promotion is only redeemable under the circumstance that the said referral has completed their sign up and is a member of world gym burpengary.

This is your Electronic Signature*

By signing your name and pressing submit you are confirming that the details are true and correct on this form.

First Last

Signature

MC Consultant*

Number of Weeks FREE - Completed by the MC*

World Gym Burpengary 159-161 Station Road, Burpengary QLD 4505 T: 07 3053 3170 E: reception@worldgymburpengary www.worldgymburpengary.com.au