The Peach House Membership Application

Peach House Membership - The Big Peach
What is your current membership status?*
Full Name*

First NameLast Name
Contact Number*
Please enter a valid phone number.Format: (000) 000-0000.
Email Address*
example@example.com
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
What amenities are you most excited about?
Reformer Pilates*

1

2

3

4

5

1 is That's Nice, 5 is WHAT?!
Mat Based Pilates*

1

2

3

4

5

1 is Not interested, 5 is Sign me UP!
Yoga*

1

2

3

4

5

1 is Next Question, 5 is Yes PLEASE!
Holistic Treatments (Dr. Katie Shea - the angel)*

1

2

3

4

5

1 is Needles are scary, 5 is Take care of my nervous system!
Holistic Facials (personalized, natural and sustainable facials) *

1

2

3

4

5

1 is Don't Touch Me, 5 is Where and when?
Women's Community Sauna*

1

2

3

4

5

1 is Sure, 5 is Hell Yes
Group Hot and Cold Plunges*

1

2

3

4

5

1 is I'll try it, 5 is Let me at 'EM!
Backyard Vibes*

1

2

3

4

5

1 is No time to hang, 5 is Coffee with friends. Yes PLEASE
A bit more about you!
How many times a week are you looking to move your body with us?*

12345+
What are your preferred class times?*

Dawn (6:00-7:30AM)Early Mornings (7:30-9:00AM)Late Mornings (9:00-11:30AM)Early Afternoon (12:30-3:00PM)Evening (5:00-7:30PM Classes)Other
Would you like to join the email list?*

YesNo
Should be Empty:

Peach House Membership - The Big Peach