Rec Plex Membership
Name
*
First Name
Last Name
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
E-mail
*
example@example.com
Rec Plex Membership Rates
Type
Monthly
3 Month
(15% Discount)
6 Month
(20% Discount)
Annual
(25% Discount)
Single
$15.00
$38.25
$72.00
$134.00
Family
$20.00
$51.00
$96.00
$180.00
Family +1
$30.00
$75.50
$144.00
$240.00
Senior
$10.00
$25.50
$48.00
$90.00
Senior Couple
$15.00
$38.25
$72.00
$134.00
Daily Rate
$5.00
Membership Type
*
Single
Family
Family +1
Senior
Senior Couple
Membership Term
*
Monthly
3 Month
6 Month
12 Month
Additional Comments
Please verify that you are human
*
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