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Shepherd Center Employee ProMotion Membership Registration

To become a member of ProMotion Fitness Center, you must complete and submit the ProMotion membership application form below and also download, complete and submit the PAR-Q Form and Member Release Form.

Plan

$50 one-time initiation fee plus $22 per month (1 adult plus 2 children)

$100 one-time initiation fee plus $22 per month (2 adults plus 2 children)

$100 one-time initiation fee plus $22 per month (2 adults)

Payment Method

Renew automatically?

If you select "Yes", we will bill the card you supply below each month for your membership fee.

Member Information

First Name

Middle Name or Initial

Last Name

Address 1

Address 2

City

State

Zip

Phone

Please provide your @shepherd.org employee email address.

Date of Birth

MM/DD/YYYY

Age

Physician's Name

Physician's Phone #

Authorized Visitors

Please provide the names of your family members who will be visiting the Fitness Center as part of your Family Membership.

Spouse's Name

First Child's Name

Second Child's Name

Authorized Visitor

Please provide the name of the other adult who will be visiting the Fitness Center as part of your Companion Membership.

Companion's Name

Payment Details

Card Number

CVC

The three- or four-digit verification code printed on your card, usually on the back.

Expiration

Expiration Month

Expiration Year

Billing Zip

Thank You

Your registration has been received. Please submit the additional forms below to complete your membership.

Physical Activity Readiness Questionnaire (PAR-Q) and Member Release Form:

Download FORM COMPLETION AND SUBMISSION INSTRUCTIONS

Download PAR-Q FORM Download MEMBER RELEASE FORM