Registration

Subscription options

Xperience Xtra : ₪340.00 ILS – monthlyXperience basic : ₪190.00 ILS – monthlyXercise : ₪250.00 ILS – monthly

Member’s name

First Name(required)

Last Name

Email(required)

Home Telephone Number(required)

Cellphone Number

Date of Birth (dd/mm/yyyy)

I.D. number

Kupat Cholim

Name of Doctor

Emergency contact number

Have you been receiving emails from Club over the last few weeks?

Yes No

Comments

Submit