Sign Up For a Membership Plan

You have elected to sign up for a family gold plan for 1 month. The initial payment is $95 plus tax. If this in incorrect, go back and change the form to the appropriate plan.

Please note that completing this membership form does not automatically activate your membership. You will need to pay the above amount upon your first visit to the club.

Contact Information:

First Name:

Last Name:

Address:

City:

State:

Zip:

Phone:

Email Address:

Confirm Email Address:

Family Information:
Second Family Member Name:		Age:
Third Family Member Name:		Age:
Fourth Family Member Name:		Age:
Fifth Family Member Name: ($15 extra per month)		Age: