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Membership Options Form
Use this form to update billing information, to upgrade your membership, or to cancel
10
Questions
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1
Please prove you are human
*
This field is required.
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2
Primary member information
*
This field is required.
Please provide the information below
First Name
Last Name
Zip code
Phone number you can be reached at
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3
Member information continued
Please provide the information below
Please enter your email
Member # (if available -- printed on member card)
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4
Please select from the following options
*
This field is required.
Update billing information
Change type of membership
Cancel membership
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5
Membership Cancellation Request
*
This field is required.
Reason for cancellation
0/500
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6
Membership upgrade request
*
This field is required.
Select the membership you would like to upgrade to
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( X )
My Bag
0
My Bag
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Great Product Name
$20
Quantity:
1
Size:
Small
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Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
Remove
Edit
Great Product Name
$20
Quantity:
1
Size:
Small
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Edit
ORDER SUMMARY
Total cost
USD
Monthly Single Membership (Recurring)
Sign up for an individual recurring monthly membership and ensure your membership never expires!
$
25
+
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Monthly Family Membership (Recurring)
Sign up your family* with a recurring monthly membership and ensure your membership never expires! *Family members may include a spouse, and up to four children under 21 years of age living at the same address.
$
30
+
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12 Month Single Membership (Recurring)
Sign up for a recurring individual 12-month membership and ensure your membership never expires!
$
300
+
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12 Month Family Membership (Recurring)
Sign up your family* with a recurring 12-month membership and ensure your membership never expires! *Family members may include a spouse, and up to four children under 21 years of age living at the same address.
$
360
+
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12 Month Single Membership (Non-Recurring)
Sign up for an individual 12-month membership.
$
300
+
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12 Month Family Membership (Non-Recurring)
Sign up your family* for a non-recurring 12-month membership. *Family members may include a spouse, and up to four children under 21 years of age living at the same address.
$
360
+
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12 Month LEO Single Membership (Non-Recurring)
Active Law-enforcement / First Responders / Military ID required. Sign up for an individual non-recurring 12-month membership.
$
225
+
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12 Month LEO Family Membership (Non-Recurring)
Active Law-enforcement / First Responders / Military ID required. Sign up your family* with a non-recurring 12-month membership. *Family members may include a spouse, and up to four children under 21 years of age living at the same address.
$
275
+
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Executive Access Membership (Recurring)
Sign up for a recurring 12-month executive membership and ensure your membership never expires!
$
1,200
+
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7
Billing information update request
*
This field is required.
Select the information you would like to update. Someone from Shoot Straight will call you to collect your new information.
I need to update credit card information
I need to update billing address
I need to update name or phone number
I need to update more than one of the above / other...
I need to update credit card information
I need to update billing address
I need to update name or phone number
I need to update more than one of the above / other...
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8
Current Drivers License / ID Number
*
This field is required.
Please enter your drivers license or state ID card number below
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9
Last 4 digits of current credit card on file
*
This field is required.
Please confirm the last 4 digits of the credit card that your membership is billed to
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10
Cardholder Signature
*
This field is required.
Please digitally sign below to authorize changes to or cancellation of your membership's billing rate/cycle
Clear
Digital Signature
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