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Membership
Details
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Your Personal Details
Club
Queens of Pole Fitness & Dance - Ormeau
First Name
Last Name
Preferred First Name
Date of Birth
Parent Name
Gender
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Gender Neutral, Non-binary
Email
Password
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Australian Capital Territory
New South Wales
Northern Territory
Queensland
South Australia
Tasmania
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Postal Code
Country
Australia
Notes
Occupation
Emergency Contact
Name
Phone
Email
Relationship
Medical Information
Behavioral Information
Start Date
First Payment Date
promo_impact_start_date
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Membership
Natty Stephens Dual Workshop Deal
Description
Natty Stephens dual workshop booking deal!
Price
$185.00 Full Cost by Billing
Promotion
$0.00 until
Account Credit
applied after sign-up
Membership Start Date
Membership Length
34 days
Prorated Upfront Fee
Transaction fees may apply
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