The Factory Performance Membership Agreement

4532 East Lone Mountain Rd

Suite 211

Cave Creek, AZ 85331

(480) 339-4887
Membership Agreement
Name*

First NameLast Name
Birthdate*
Second Membership Name

First NameLast Name
Birthdate
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
In Case of Emergency (Name)*
Emergency Phone Number*
Email*
example@example.com
How did you hear about us?*
T-shirt Size*

SmallMediumLargeX-Large2 XL3 XL
Cancellation Policy: 30 day cancellation notice
Default & Late Payments: Should you default on any payment obligation as called for in this agreement, The Factory Performance will have the right to declare the entire remaining balance due and payable and you agree to pay allowable interest, and all cost of collection, including but not limited to collection agency fees, court costs, and attorney fees. A default occurs when any payment due under this agreement is more than ten days late.

Service Fee: A service fee of $25 will be charged immediately for any check, draft, credit card, or order returned for insufficient funds or any other reason. Should any monthly payment become more than 10 days past due, you will be charged a late fee.

My Products*

Unlimited Monthly MembershipDiscounted to $199.00 with coupon code FIRST40

$299.00

2x Per Week Monthly Membership

$199.00

1 x Per Week Monthly Membership

$149.00

Drop In Class Rate

$40.00

Sibling Membership

$169.00 Quantity

Enter coupon

Total

$0.00

I hereby request the privilage of paying to Swipe CC ("The Company") The Factory Performance, and further authorize the Company to draw items (checks, electronic fund transfers, credit card) for the purpose of paying payments including any late fees or service fees, on account of.
Parent or Guardian signature if member is a minor (Under the age of 18)
Signature*

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