Mel’s Total Fitness Membership

Mel’s Total Fitness Membership
Date Joined

MonthDayYear
2 digit month, 2 digit day, 4 digit yearDate
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number
Please enter a valid phone number.Format: (000) 000-0000.
Email
example@example.com
D.O.B.
Bank Name (this info is for monthly drafts starting in October )
Routing # (this info is for money drafts starting in October )
Account # (this info is for monthly drafts starting in October)

Choose One

1 Year Membership/$59 Month 2

Today is your payment for this month. Next Month you will be drafted on the 5th

Gym Access

Unlimited Classes

Discounted Boot Camps

No Registration Fees

Monthly Draft for 12 Months

$59.00

6 Month Membership/$65

Todays Payment is for this month!! Next month you will be drafted on the 5th

Gym Access

Unlimited Classes

Discounted Boot Camps

No Registration Fees

Monthly Draft for 6 Months

$65.00 Quantity

Mother/Daughter Membership/$69

Gym Access

Unlimited Classes

Discounted Boot Camps

No Registration Fees

Monthly Draft for 12 Months

$69.00 Quantity

6 Month Pre-Pay Membership/$390

Gym Access

Unlimited Classes

Discounted Boot Camps

No Registration Fees

$390.00

12 Month Pre-Pay

Gym access

Unlimited Classes

Discounted Boot Camps

No Registration Fees

$590.00

Total

Payment Methods

Credit Card

Cash App Pay

Signature
Should be Empty: