Free Trial PLEASE FILL OUT THE FORM BELOW Name (person interested in a free trial)* First Last Email* Mobile*Home PhonePreferred day for inductionMondayTuesdayWednesdayThursdayFridaySaturdaySundayPlease use drop down menu to indicate.Preferred timeMorningAfternoonEveningPlease use drop down menu to indicate. Please note the Centre is only open until 5pm Saturdays and Sundays. Do you have a membership is mind?UnsurePay as You Go userFull MembershipOff Peak MembershipCorporate MembershipSenior MembershipJunior MembershipFamily MembershipAnnual Student MembershipPay Monthly Student MembershipConcessions MembershipPlease use drop down menu to indicate.Terms and Conditions* Yes I agree By giving this information I am giving Portland Centre Staff permission to contact me, in order to talk to you about your trial at Portland Centre, and receive more information about Memberships.Tick if you would not like to be sent and communications via email or phone after your tour is complete. NameThis field is for validation purposes and should be left unchanged.
