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HealthyClub Registration Form

If you're a HealthyClub card holder, please fill out and submit the following simple form to register yourself as a member of the online HealthyClub.

If you are not HealthyClub card holder, You'll have to fill out this Form to register.

Simple Registration Form:
Your HealthyMember Number.
--  <-- At the back of your member card.
Choose your User Name. 
  <-- The name to be viewed in HealthyClub.
Choose your Password:
Re-enter your Password again for verification:
 <-- Make sure it's the same as Password.
Your Birthday:
Month      Day
Enter your E-mail Address:
<-- This is how we'll send you HealthyNews.
 Yes, I would like to receive further newsletter from HealthyNest.
In case you forget your password
If you forget your password, you'll be asked a questions you specified below. We'll send you a new password to the email address you provide above, so make sure it is correct.
Your Question:
Your Answer:



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Last modified: October 05, 2004