Retired Military Membership Promotion Application

RETIRED MILITARY MEMBERSHIP PROMO APPLICATION

$170/MONTH BASE RATE (CURRENT MILITARY ID CARD REQUIRED)
Credit card or bank account information is required for this membership. However, due to the sensitive nature of this form, please provide your payment details in person at the club or by calling 360-675-5490 ext. 1.
Name*

First NameLast Name
Email*
example@example.com
Date of Birth*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
SPOUSE INFORMATION (Optional add-on)

$63.00/MONTH
Spouse Name

First NameLast Name
Spouse Email
example@example.com
DEPENDANTS

$20/MONTH ($40 Max)
Dependant 1

First NameLast Name
Dependant 2

First NameLast Name
Dependant 3

First NameLast Name
An application fee and the last 3 months deposit will be due at sign up.

Application Fee: $50.00+Last 3 Months Deposit ($170.00+$10.15 tax) X3= $590.45 (Family member add-ons will be charged monthly)

The next billing date on all memberships will be on the last day of each month. The first month will be pro-rated.

*This application will require the applicant to physically come in or call (360-675-5490 ext. 1) and provide financial information for billing.
Notes:
Anything you need us to know?
Should be Empty:

RETIRED MILITARY MEMBERSHIP PROMO APPLICATION