Membership Application Form

Membership Application Form

Applications must be submitted 72 hrs before use. All Applications will be subject to verification. All Applicants must be 18 yrs or older to apply for any Membership or have Parent or guardian apply for membership.
Customer Details:
Full Name

First NameLast Name
Home Address

Street Address

Street Address Line 2

CityState / Province / Country

Postal / Zip Code
Date of Birth

MonthDayYear
Date
Phone Number
Format: (000) 000-0000.
E-mail
example@example.com
File Upload (Valid: ID/ DL / Passport)

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File Upload (Parent or Guardian Valid: ID/ DL / Passport) If applicable*

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Company Name
Company / Store Address

Street Address

Street Address Line 2

CityState / Province / Country

Postal / Zip Code
Job Tittle

Other
For BLACK CARD Applicants ONLY: Submit (Business License / Tax ID Form / W9 Production Companies)

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Which Membership are you Interested in purchasing?

Please give 2 business references:

Rows	Full Name	Address	Contact Number
1
2

Please give 2 Emergency Contacts:

Rows	Full Name	Relationship to you	Contact Number
Person #1
Person #2

How did you hear about us?
Your Prefered Method of Contact
Disclaimer: Age Verification and Liability Waiver • Age Requirement: Memberships will not be sold to individuals under the age of 18. • Liability Waiver: Children under the age of 18 must have a parent or legal guardian sign a liability waiver before purchasing a membership. Membership Terms and Conditions Acknowledgment: Do you agree to: 1. Uphold the confidentiality of all activities, discussions, and materials associated with this membership; 2. Abide by the organization’s code of conduct and values; and 3. Understand and accept the expectations, payments, or minimums required for your chosen membership?
I understand that by signing the below I will have to pay $$- $$$ upon approval of this Application.
I understand that by signing and checking off this box below, i agree to the following: Disclaimer: Age Verification and Liability Waiver 1. Age Requirement: Memberships will not be sold to individuals under the age of 18. 2. Liability Waiver: Children under the age of 18 must have a parent or legal guardian sign a liability waiver before purchasing a membership. Membership Terms and Conditions Acknowledgment: Do you agree to: 3. Uphold the confidentiality of all activities, discussions, and materials associated with this membership; 4. Abide by the organization’s code of conduct and values; and 5. Understand and accept the expectations, payments, or minimums required for your chosen membership? 6. I understand that by signing the below I will have to pay $$- $$$ upon approval of this Application.
Disclaimer signature.
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