Club Membership Registration Form

We Believe Wellness Center

Complete the form below to sign up for our membership service.
Name

First NameLast Name
E-mail
Phone Number

Area CodePhone Number
Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip CodeCountry
Birth Date

MonthDayYear
Where did you hear about us?

A Friend or colleaugeGoogleBlog PostNews ArticleOther
If "other" please take a moment to tell us how you heard about us?
Membership Type

Healing with PurposeHealing in ProgressStart to Healing
Preferred way to contact

PhoneEmailAny
Membership Rules
1. Membership is available to anyone 18 years of age or older.

2. You promise NOT to use to conduct any fraudulent or business activity or have more than one Member Account at any time.

3. Smoking/Vaping on or near the Wellness Center is strictly forbidden. This offense could result in membership temination.

4. Consumption of Alcohol on or near the Wellness Center is strictly forbidden. This offense could result in membership temination.

5. Tampering with any of the healing machines other than what is stated in the directions posted will results in fines up $50,000+

6. When up driving to the Wellness Center please be mindful of the SPEED at which you drive.

7. We have a zero tolerance policy for any crude, hateful, rude or inappropriate laungage.
Initials*
I have read, understood, and accepted the rules for membership.
Privacy Policy
Please reach out and read our Privacy Policy in order to understand how your information is used and shared, and check below if you accept the policy.

www. WeBelieveAZ.com
I have read, understood, and accepted the PRIVACY POLICY for membership.
Once you submit your application, we will contact you shortly to complete your membership application.

Thank you!
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We Believe Wellness Center

Membership Rules

Privacy Policy