Universal Lifestyle, a division of Universal Healthcare Services (Pty) Ltd, Registration no 2008/005871/07Status House, 15 Tambach Road,Sunninghill Park, Sandton, 2191

PO Box 1411, Rivonia, 2128

Telephone: +27 11 208 1000Facsimile: 086 504 1545

E-mail: lifestyle@universal.co.zawww.lifestyle360.co.za

PLANET FITNESS APPLICATION FORM 2011

Access Planet Fitness through Universal Lifestyle Being fit means being healthy, strong and toned. Increased health awareness has shown us that

a consistent fitness regime is key to balance and wellness, and if that is what you’re aiming for then Planet Fitness is part of the plan. Plus, if you are a Universal Lifestyle member it’s easier AND cheaper. What more is there to say?

Do I qualify?Yes, yes and yes again! Everyone has the right to get fit.

What does it cost?Well first of all, as a Universal Lifestyle member your activation fee will be waived. Thereafter

there is a once-off tag fee of R100 and a monthly debit order at a discounted rate or a once off fee at a discounted rate in accordance with the option you choose. You can check the price structure in the table below.

Where do I sign up?Please see the instructions and application form below.

PLANET FITNESS CLUBS AND RATES FOR LIFESTYLE LITE

ONE YEAR MEMBERSHIP

Planet Fitness joining fees Normal Planet Fitness Joining fees

Joining fee waived for Lifestyle members paying by debit order

Joining fee waived for Lifestyle members paying upfront

Joining fee R300 - R900 R 0.00 R 0.00

Planet Fitness Clubs Normal Planet Fitness rates Due from member after 10% discount on monthly debit order

Due from member after 15% discount over 12 months on once off fee

Fourways (Lonehill)Village Walk Craighall Centurion gate (Centurion Mega Club)Witbank

R 355.00 R 319.50 R 3 621.00

Parklands (Tableview) R 365.00 R 328.50 R 3 723.00Bedfordview R 415.00 R 373.50 R 4 233.00Benoni Roodepoort PE Hennops (Centurion)Moreleta

R 285.00 R 256.50 R 2 907.00

Plattekloof Rivonia Wanderers Rosebank

R 375.00 R 337.50 R 3 825.00

Durbanville Cobble Walk FairmountClaremontMontana

R 275.00 R 247.50 R 2 805.00

Soneike R 245.00 R 220.50 R 2 499.00

Planet Fitness National Access Normal Planet Fitness rates Due from member after 10% discount on monthly debit order

Due from member after 15% discount over 12 months on once off fee

National access R 499.00 R 449.10 R 5 089.80

PLANET FITNESS CLUBS AND RATES FOR LIFESTYLE 360°

ONE YEAR MEMBERSHIP

Planet Fitness joining fees Normal Planet Fitness Joining fees

Joining fee waived for Lifestyle members paying by debit order

Joining fee waived for Lifestyle members paying upfront

Joining fee R300 - R900 R 0.00 R 0.00

Planet Fitness Clubs Normal Planet Fitness rates Due from member after 20% discount on monthly debit order

Due from member after 25% discount over 12 months on once off fee

Fourways (Lonehill)Village Walk Craighall Centurion gate (Centurion Mega Club)Witbank

R 355.00 R 284.00 R 3 195.00

Parklands (Tableview) R 365.00 R 292.00 R 3 285.00Bedfordview R 415.00 R 332.00 R 3 735.00Benoni Roodepoort PE Hennops (Centurion)Moreleta

R 285.00 R 228.00 R 2 565.00

Plattekloof Rivonia Wanderers Rosebank

R 375.00 R 300.00 R 3 375.00

Durbanville Cobble Walk FairmountClaremontMontana

R 275.00 R 220.00 R 2 475.00

Soneike R 245.00 R 196.00 R 2 205.00

Planet Fitness National Access Normal Planet Fitness rates Due from member after 15% discount on monthly debit order

Due from member after 20% discount over 12 months on once off fee

National access R 499.00 R 424.15 R 4 790.40

Planet Fitness Platinum Normal Planet Fitness Platinum rates

Due from member after discount on monthly debit order

Due from member after discount over 12 months on once off fee

Planet Platinum joining fee R 1 095.00 R 0.00 R 0.00R 1 095.00 R 980.00 R 11 760.00

Planet Platinum Sandton No joining fee and members receive an additional two months membership for free at Platinum when paying upfront - 14 months for 12 months membership fees

Universal Lifestyle 360° membersStep 1: Activate your Universal Lifestyle 360° benefit

• Activate your Lifestyle 360° membership by calling 086 155 LIVE (5483) and completing the application form. You can also access the Lifestyle 360° application form at www.lifestyle360@universal.co.za.

• You have one month from the time you become a Planet Fitness member to activate your Lifestyle 360° membership for access to the discounted rates.

• If you don’t sign up during this month you will be billed the standard Planet Fitness rate for the duration of your contract.

Step 2: Go to Planet Fitness and sign the form• Read, complete and sign the application form.• Provide the consultant with your Universal Lifestyle 360° membership number and identity document.

Step 3: Pay the tag fee and first month’s gym fees to the Club• Pay the R100 tag fee at the Planet Fitness facility either by cash or credit card.• Pay the first month’s membership fee to the Club either by cash or credit card.• Hand in your signed application form and debit order form to a consultant at your selected Planet Fitness club.

Step 4: Get your body moving• You will be given a Planet Fitness access tag and have immediate access to the Planet Fitness facility.• A fitness consultant from Planet Fitness will contact you to help you get started with your exercise programme.

Universal Lifestyle Lite membersStep 1: • Note: This basic Universal Lifestyle option is available to all principal members of medical aid schemes administered by Universal Healthcare Administrators as well as VIP stakeholders such as Universal brokers and Universal Network healthcare providers. As a VIP stakeholder you need to activate your Lifestyle Lite membership by completing the application form. You can access the Lifestyle Lite application form at www.lifestyle360@universal.co.za or call 086 155 LIVE (5483).

• You have one month from the time you become a Planet Fitness member to activate your Lifestyle Lite membership for access to the discounted rates.

• If you don’t sign up during this month you will be billed the standard Planet Fitness rate for the duration of your contract.

Step 2: Go to Planet Fitness and sign the form• Read, complete and sign the application form.• Provide the consultant with your Universal Lifestyle Lite membership number and identity document.

Step 3: Pay the tag fee and first month’s gym fees to the Club• Pay the R100 tag fee at the Planet Fitness facility either by cash or credit card.• Pay the first month’s membership fee to the Club either by cash or credit card.• Hand in your signed application form and debit order form to a consultant at your selected Planet Fitness club.

Step 4: Get your body moving• You will be given a Planet Fitness access tag and have immediate access to the Planet Fitness facility.• A fitness consultant from Planet Fitness will contact you to help you get started with your exercise programme.

HOW TO ACTIvATE YOUR PLANET FITNESS MEMBERSHIP THROUgH UNIvERSAL LIFESTYLE

Please noteYou will have access for as long as you remain a valid member of Universal Lifestyle and as long as Planet Fitness remains a Universal Lifestyle

partner. You cannot transfer your rights herein. Under no circumstances are any fees refundable. This benefit is subject to the rules of Universal Lifestyle.

I hereby wish to have access to Planet Fitness through Universal Lifestyle.

Lifestyle 360° membership no.: OR Lifestyle Lite membership no.:

Starting date: Term of contract: One year Two years

Home club: Contact no.:

I have selected the following membership: Local: National: Platinum:

Personal detailsTitle: Initials: First name(s):

Surname: ID/Passport no.:

Date of birth: Tel no. (work):

Cell no.: E-mail address:

Physical address: Postal address:

Name of general practitioner: Contact no.:

Spouse and dependants details (only applicable on Lifestyle 360° membership)Only if they are Universal Lifestyle 360° members can they have access to Planet Fitness at the discounted rates.

Initials Name(s) Surname ID/Passport no. Relation to main member Cell no.:

I choose to pay: By debit order The once off annual fee The once off two year fee

Bank account details for debit orderAccount holder name: Bank:

Bank account no.: Branch name:

Branch code: Account type: Savings Cheque

I hereby authorize Universal Lifestyle to deduct any monthly fees from my bank account that may become due in terms of this benefit. I am aware and accept that these fees may change from time to time on notification from Universal Lifestyle. I also accept that the debit order may be adjusted should I fail to meet the minimum visitation criteria once it is implemented.

Should my banking details change at any time, I understand that I am required to inform Universal Lifestyle of the change so the details can be updated on the system. I have familiarized myself with the terms and conditions of this benefit as contained in this form and the terms and condi-tions of Universal Lifestyle, and will adhere thereto. In the event of a conflict arising between the terms and conditions of Universal Lifestyle and the contents of this form, the terms and conditions of Universal Lifestyle will prevail.

Signature (client): Date:

I, the undersigned, hereby confirm that the information provided by me and contained in this membership agreement is correct and further confirm that I have read, understood and accepted the terms and conditions of this membership as it appears in this application form. I further warrant that I suffer from no physical or mental ailments that will affect my application for membership.

Member signature: Date:

Signature (assisted by legal guardian): Date:

Capacity (mother/father): Date:

Consultant: Date:

MEMBERSHIP DETAILS

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

D D M M Y Y Y Y

I, the undersigned, do acknowledge and agree that:

• I have contracted directly with Planet Fitness to access Planet Fitness and that I am legally bound to settle any amounts due for such access to Planet Fitness.

• This agreement is also subject to the terms and conditions of the agree-ment entered into between Planet Fitness (“the company”) and Uni-versal Lifestyle.

• I have familiarised myself with the rules of Universal Lifestyle 360° and shall adhere thereto.

• I have entered into this agreement by virtue of my participation in the

Universal Lifestyle programme, a division of Universal Healthcare Ser-vices (Pty) Ltd.

• I will be entitled to use and access the health and leisure facilities of the company subject to:

• Confirmation from Universal Lifestyle of my Universal Lifestyle mem-bership.

• I accept that if I join Planet Fitness and I do not activate Universal Life-style within one month Planet Fitness will bill standard Planet Fitness rates for the remainder of the term, after which it will continue on a monthly basis until we receive one month’s notice to cancel.

• Payment of the prevailing access tag fee

1. Signature of this form

2. Payment of monthly debit order to Universal Lifestyle/payment of the once off fee to the company.

3. My compliance with the rules and regulations of the Planet Fit-ness benefit and the terms and conditions of this agreement.

• I acknowledge that I am not entitled to suspend my Planet Fitness access.

• In the event that my membership of Universal Lifestyle ends, my right to access Planet Fitness in terms hereto will also be automatically terminated.

• My contract agreement will be transferred to Planet Fitness if I cancel the benefit with Universal Lifestyle or cancel my Universal Lifestyle membership. I am aware that I will be required to honour my contract for the full term with Planet Fitness at the full relevant retail rate of the facility.

• I will ensure that my visits to Planet Fitness are recorded accurately by using my access card. It is my responsibility to ensure that my visit is recorded in the register should the system used for recording points not be operational.

• I am physically and medically fit to proceed with the normal routine of exer-cise and acknowledge that the company, Universal Lifestyle and any mem-ber of the Universal Healthcare Group of companies will not be responsible for any injury or loss suffered by me/or the junior member(s), whether through any negligence and/or omission on the part of the company or for any reason whatsoever. In the event of my signing this agreement as the guardian of a minor, I hereby consent to the minor being bound to the terms of conditions of this agreement and I indemnify Universal Lifestyle

TERMS AND CONDITIONS OF PLANET FITNESS ACCESS

and the company for any loss and damages arising from any claim resulting from the minor’s use of and access to the facilities.

• I accept that the company may require me to pay for use of additional services and facilities specified from time to time. The company will charge the same general tariffs charged to ordinary members of the public for such additional services and facilities. The terms of this agreement do not pertain to such additional services and/or facilities.

• I accept that access to the company’s facilities will be denied until such time as the company has received payment in full of any arrear fees.

• I accept that the company and Universal Lifestyle reserve the right to can-cel my access if I breach any of the terms and conditions of this agreement or any rules and regulations applicable at this facility.

• In the event of one or more of these terms, conditions, rules and/or regulations being unenforceable, the same will be deemed to be sever-able from the remainder of this agreement.

• I confirm that the information contained herein is true and correct. I understand that I cannot cede or assign any of the rights or obligations in this agreement to any third party.

• Universal Lifestyle and the company reserve the right to cancel this agreement if the information supplied is incorrect.

• I accept that Universal Lifestyle will be entitled to amend the terms and conditions hereof at any time on the proviso that the amendments are communicated to me in writing and are furnished to me timeously.

• The company may transmit details of my usage records of the facilities to Universal Lifestyle.

I authorize both Universal Lifestyle and the company to disclose to one another personal information pertaining to my Universal Lifestyle member-ship and my access to the facilities from time to time on the proviso that such information is kept confidential.

I have read this entire agreement inclusive of the rules and regulations applicable at the facility, a copy thereof was provided to me and agree to be bound thereby.

Signature (client):

Signature of legal guardian:

(if the member is under 21 years of age)

The rules and regulations will be displayed where applicable and are avail-able upon request. The client undertakes to abide by all the rules and regulations as set out by management and confirms that they understand them fully.

Access cards

Access cards are for the exclusive use of the client. No client will gain access to the facility without a card. Loaning of access cards to other mem-bers and non-members is prohibited. Should a non-client present a client’s card, Planet Fitness will confiscate the card and the member’s membership shall be summarily terminated at the sole and absolute discretion of Planet Fitness. Lost or stolen cards may be replaced at a fee stipulated by manage-ment. If a membership card is left at home, access will be permitted upon the member displaying an identity document or driver’s license.

Access fees

The member will not be released from their obligation regarding any payment of the membership fees as agreed to herein. The member is not en-titled to any deduction or allowance for any payment made, by reason of the member’s absence or withdrawal from the club, nor by the member’s failure to attend or to use the facility. Membership fees are strictly non-refundable.

Ancillary charges

Further charges may be levied for private training sessions, diet plans, assessments and similar additional services.

Reciprocal facility

Planet Fitness does not guarantee nor take responsibility for the avail-ability or usage of any reciprocal facility not owned by Planet Fitness. The member indemnifies Planet Fitness against inconvenience suffered as a re-sult of the above unavailability, whether temporary or permanent and un-dertakes not to institute any claim and/or action against Planet Fitness in relation to the above. Reciprocal facilities cannot be used on a full-time basis and certain facilities may charge an additional fee at their discretion.

Closure of facility and/or alteration of hours

Should the facility deem it necessary, in the sole and absolute discretion of the facility, to perform maintenance work on the premises, the facility can close for the period required for completion of the necessary maintenance.

If, in the sole and absolute discretion of the facility and due to unforeseen circumstances, a facility has to be closed on a permanent basis, Planet Fitness reserves the right to provide an alternative facility, within a 25km radius.

The business hours will be displayed at the premises and the facility reserves the right to alter the business hours from time to time, as it deems fit. The classes may be discontinued or the time altered at the sole discretion of the facility. Equipment and classes shall be provided subject to demand.

Children

Certain restrictions apply to children under the age of 18. Please refer to a consultant at your branch for details in this regard.

RULES AND REgULATIONS

Right of admission to facilities reserved

Right of admission to Planet Fitness South Africa (PTY) Ltd. (‘the Company”) is reserved.

Limitation of liabilities

Planet Fitness will not be liable or responsible for any theft, death, harm, damage, injury, loss or damage suffered by the member and/or their depen-dants and/or estate through or contributed to any cause whatsoever, including but not limited to any negligent (including gross negligent) act which occurred while the member and/or their dependants used the facilities, which facilities the member warrants they are sufficiently fit to use, nor shall Planet Fitness be liable for any act or omission or breach of contract on the part of Planet Fit-ness, its directors, employees, contractors, independent consultants or other member/s. It is the member’s sole responsibility to ensure that they are suf-ficiently fit to take part in any exercise or activity offered by Planet Fitness. The member indemnifies Planet Fitness for any suffered due to faulty equipment and/or injury sustained by the member either inside or outside of the facility. I agree and acknowledge that I enter upon and exit the premises including park-ing areas and use the equipment and facilities entirely at my own risk.

Clothing and hygiene

The club reserves the right to deny use of the club to any person whose at-tire is not considered being appropriate in connection with the public image of the club and its rules and regulations. Athletic shoes are required in all exercise areas. No black-soled shoes are permitted on the squash courts or aerobics floor. Clients must use a sweat towel at all times and must wipe equipment before proceeding to the next station. No member may exercise without a top. Proper swimming attire is required to be worn whilst utilising the pool area, steam rooms and saunas. Clients are required to wear swimming caps when utilising the pool. Clients are required to shower before entering the pool.

valuables and personal property

Planet Fitness will not be responsible for any loss, theft or damage to personal property of the member, dependant, guest or any third party. The member waives the right to sue the facility for any loss, theft or damage to personal property.

Non-variation of agreement

This is the entire agreement between the parties and no representation, promise, warranty and/or agreement not contained herein shall be any force and effect between the parties. No extension of time or indulgence granted to the client will prejudice the rights of the facility in terms of this agreement.