Register for Membership | POWERSURGE GYM & NUTRITION

Online Membership Registration

No account or password needed — submit your details below, then visit or contact the POWERSURGE GYM & NUTRITION office to complete your payment and activate your membership.

Fields marked * are required. Everything else is optional.

Personal Information

Full Name *

Phone Number *

Emergency Contact Number *

Email (optional)

Address *

Gender (optional)

Date of Birth (optional)

Current Weight (kg) (optional)

Target Weight (kg) (optional)

Profile Picture (optional)

JPG, PNG or WebP, up to 2MB. Leave this empty and we'll use the POWERSURGE logo until you bring a photo to the office.

Membership Interest

Preferred Package *

Preferred Trainer (optional)

Coupon Code (optional)

Leave blank if you don't have a coupon — it won't affect your registration.

Notes (optional)

Payment

Pay at Gym Register now, pay when you visit the office.

Online Payment Pay now with bKash or Nagad and upload your receipt.

Scan the QR on the gym's payment card, or pay to the merchant number shown here.

Merchant number: 01612839232

Use "Payment" only — "Send Money" is not accepted. শুধু মাত্র Payment করুন, Send Money প্রযোজ্য নয়।

Please make the payment using the QR code above. After completing the payment, enter your Transaction ID (TrxID) and upload a screenshot of the successful payment.

A 1.3% charge applies to bKash and Nagad payments. বিকাশ বা নগদ পেমেন্ট এর জন্য ১.৩% চার্জ প্রযোজ্য।

⚠️ Only complete (successful) payment screenshots are accepted. Membership will be activated only after admin verification.

Payment Method *

Payment Type *

Transaction ID (TrxID) *

Payment Screenshot *

JPG, JPEG, PNG or WebP, up to 5MB. You'll need to pick the file again if the form comes back with an error.

Prefer to pay in person? Choose Pay at Gym above — simply visit the POWERSURGE GYM & NUTRITION office and pay there once you arrive.

Already registered? Visit or contact the POWERSURGE GYM & NUTRITION office to complete your payment.