MEMBER  REGISTRATION
 
      Membership Type: Platinum Membership
     Monthly Dues: $ 34.99
      Term: Month to Month
      First Month Dues*: $ 37.44
      Total Due Today: $
     Billing Starts 01/01/2022
     
*Prorated w/ taxes    
     
 PERSONAL  INFORMATION
   
     First Name / MI
     Last Name
     Address 1
     Address 2
     City / State
     Zip
     Driver License #
   
   
Birthday
Home Phone
Cell Phone
E-Mail
Confirm E-Mail
Emergency Contact
Emergency Phone
Hear About us?
   
 
 BILLING  INFORMATION
 
    How would you like to pay for your monthly dues?
     I want to use my credit card. ($2.50 per month service charge for credit card)
     I want to use my bank account.
    
    How would you like to pay today?
    Credit Card Type
    Credit Card Number
    Expiration Month/Year /
   
    Discount Code  
 
 TERMS  AND  CONDITIONS
 
 I have read and agree to the 24 hour rules and regulations.
 I have read and agree to the waiver and release form.
 I have read and agree to the general policies and procedures.
 I have read and agree to the membership terms and club rules.
 I have read and agree to the annual fee.
 
 
Member
 
Parent/Guardian