REPs Facility Registration Form 2017-2018

If your facility is already registered and you want to re-register for the coming year, you need to log in first. If this is your first registration, please continue below.

The fee to register an exercise facility is based on the number of exercise professionals only operating from the facility). The annual fee ranges from $195 for small (up to 9 exercise professionals), $295 medium (10-14), or $495 for a large facility (15 or more exercise professionals) + GST. Please complete all of the fields below, and you will then be taken to the payment page. For further assistance you are welcome to call us on 0800 55 44 99.

All fields marked with a * must be completed.

Facility Details

Facility Name: *
Legal Name: *
(Limited Liablity, Sole Trading Name etc)
Number of Exercise professionals based at this facility: *
Street Address: *
Town/City: *
Postcode: *
If you do not know your postcode, click here.
Postal Address: *
Phone 1:
Phone 2:
Website:
Facebook:

Owner Details

Owner:
Owner's Email:
Owner's Phone:

Facility Manager Details

Tick if same as above or complete below.

Manager:
Manager's Email:
Manager's Phone:

Fitness/Exercise Manager Details

Tick if same as Owner above or complete below.

Manager:
Manager's Email:
Manager's Phone:

Primary Contact

Primary Contact Person:
the person to undertake re-registrations and other administrative items for the facility registration