Crunch Membership Request

Crunch Membership Request Form

Please Note: This DOES NOT give you membership to Crunch. This form is sent to Crunch to verify eligibility and complete the membership process.
Name*

First NameLast Name
E-mail*
example@example.com
Cell Number*
Are you a member of the YourChoice Health Plan (or will be effective 1/1/2026)*

YesNo
Only members on the YourChoice Health Plan are eligible for this Crunch Membership.
Are you a current member of Crunch?*

YesNo
ATTENTION CURRENT CRUNCH MEMBERS:
Any current Crunch member must GO IN to their local Crunch front desk to CANCEL their current membership and ensure December is their last billing period. YourChoice is a new membership and memberships CANNOT be transferred.
Should be Empty:

Crunch Membership Request Form