Membership Signup

Name

First NameLast Name

Email

example@example.com

Phone Number

Please enter a valid phone number.

Birth Date:

Date

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Emergency Contact Name:*

Emergency Contact Phone:*

Please enter a valid phone number.

I understand that if I select monthly payments, my membership is on a month-to-month basis and set up on an automatic bank or credt card draft payment. I know that my month to month membership can be cancelled at any time by simply providing OsteoStrong with a 30-day written notice to cancel.

I authorize and request that OsteoStrong automatically withdraws my monthly fee from the payment method listed below on the first day of each month. I request that this automatic withdraw begins now or at the end of my trial or special offer period and remains in effect until I provide a 30 day written notice to cancel my membership.

If I wish to pause my membership fees, I can for up to 60 days @ only $25 per month by requesting to place my membership on hold and providing OsteoStrong with the dates prior to the 25th of the month.

If I select a yearly payment, special offer, 10 session pass or any upfront payment option I authorize a one off payment in full for the option selected below and understand there are no refunds.

New York State taxes of 8.875% are applicable and are added to the amount OsteoStrong charge.

A $299 cancelation fee is applicable on 12 and 18 month memberships if terminated earlier than the agreed term.

Membership Selection*

Signature*

OsteoStrong Flatiron