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Energize Membership Application Form


Primary Member Information

Family Membership Information

If applying for a family membership, please provide additional information for each family member:

**A separate Physical Activity Readiness Questionnaire must be completed for each family member.

**Each adult must sign a Waiver & Release Form (children can be included on the adult form).

Family Member 1

Family Member 2

Family Member 3

Family Member 4

Family Member 5


Additional Information

Please submit together with the Application Form, the Physical Activity Readiness Questionnaire, the Waiver and Release Form and passport photos to the UNIS Hanoi Activities Office (B7 2nd Floor – Room 112) during school hours. You will receive a bill from the Business Office upon which payment can be settled. Memberships become active once payment has been received.

Community Members are those persons who are UNIS Hanoi employees or parents, including their spouse and children.

Memberships: An individual membership is for one person only. A family membership is for more than one person. Membership provides access to and use of both the swimming pool and fitness room. There is no separate pool or fitness room membership.

New Families will be eligible to become Energize members on the first day of the school year or at that point during the school year when the child becomes an attending student at UNIS Hanoi.

United Nations International School of Hanoi

©2013 United Nations International School of Hanoi
G9 Ciputra | Lac Long Quan Road, Tay Ho District
Hanoi, Vietnam | Ph (84 4) 3758 1551 | info@unishanoi.org

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