Total Body Gym Membership Enrollment

Total Body Gym Membership Enrollment
MEMBERSHIP REGISTRATION
HAVE YOU BEEN A MEMBER @ TOTAL BODY GYM IN THE PAST *
Select One
WHEN

Month Day Year
Date
Members Name *

First Name Last Name
Male / Female *
How did you hear about us?

Member Referral Social Media Location
Members Name:
Member's information *
Please note that anyone under 18 will need a parent or guardian to come by the gym & sign the membership.

Current Address *

Street Address
Street Address Line 2
City	State
Zip Code	Country

Email *

Confirmation Email example@example.com
Cell Phone Number

Area Code Phone Number
Home Phone Number

Area Code Phone Number
In Case of Emergency:
MEMBERSHIP AGREEMENT & INFORMATION
The membership term will begin on the following date for 12 Months.
*

Month Day Year
Date
IN ACCEPTING BELOW, I AGREE TO PAY 12 CONSECUTIVE MONTHLY INSTALLMENTS OF $19.99 DUE STARTING FROM THE DATE SHOWN ABOVE AND EACH MONTH THEREAFTER UNTIL THE AMOUNT IS PAID.

My Products

Enrollment / Card Fee $ 99.00

1st Month's Membership Dues $ 19.99

Quantity

Unlimited Tanning for 12 months (Monthly Rate) $ 15.00

Quantity

Online Service Fee $ 5.00

Enter coupon

Total $ 0.00

Credit Card
First Name	Last Name
Credit Card Number	Security Code
Expiration Month	Expiration Year
Street Address
Street Address Line 2
City	State / Province
Postal / Zip Code	Country

Please verify that you are human
Annual Rate Guarantee / Billing Maintenance Fee: $39.99 on 09/05/2020.
I agree to the annual club rate/ maintenance fee of $39.99 for this year and each year thereafter for the duration of the membership to guarantee my low monthly rate, and to maintain equipment and services provided by the facility. This annual fee will be collected through my current means of billing.
CHECK BELOW TO ACCEPT the Annual Rate Guarantee / Billing Maintenance Fee: $39.99 due on 09/05/2020 *
Auto Renewal: Following your initial term, this agreement continues automatically for 12 Months, at your current rate(s), The membership will be renewed automatically for an additional 12 months on each anniversary of the "membership begins" date, until a 30-day advance written notice received by the facility at the address provided herein. MONTHLY DUES MUST BE CURRENT TO TERMINATE.. NO REFUNDS WILL BE ISSUED
Membership Auto Renewal - CHECK BELOW TO ACCEPT *
I AGREE, and understand that I may cancel this agreement with five (5) business days after the above date of this agreement. BUT, such cancellation must be via certified mail to the facility to the address above. Failure to utilize the facility is not a cause for cancellation and failure to utilize the facility does not relieve member of payment. I agree and understand this membership is subject to the terms and conditions set forth herein and that additional club policies or rules apply. I voluntarily agree to participate in these activities and therefore assume any and all such risks. I waive, release and hold the facility, its employees, agents or representatives harmless from any all such claims or actions.

TOTAL BODY GYM will NOT tolerate facility abuse and disrespect. Members are expected to act with utmost decency, common courtesy and decorum. Total Body Gym will provide a comfortable atmosphere for fitness and 24 hour video surveillance will monitor all permitted areas. In the event of facility abuse, i.e. damage to equipment, mirrors, fans, walls, televisions, vending, plumbing, including sinks and showers; the individual(s) who inflict such abuse and/or damage shall be financially responsible for the repair/replacement of equipment in the event of damage to the Total Body Gym premises. Cost will be automatically withdrawn by current means of member billing.

HAVING READ ALL OF THE ITEMS OF THIS AGREEMENT IN THEIR ENTIRETY, understanding completely all of the consequences therein, and intending to be legally bound to hereby, I HAVE AFFIXED MY SIGNATURE ON THIS DOCUMENT. By signing below, buyer acknowledges reading, agreeing and receiving a completed copy of this entire agreement. (Including pdf information sheet to opened and read and/or printed.)
Signature *

Clear
ELECTRONIC FUNDS TRANSFER (EFT) AUTHORIZATION AND ACCEPTANCE
In signing below, I authorize my Bank or Credit Card Company to make payment to ASF or Total Body Gym via the following means and I agree to inform facility of any bank or credit card changes that may affect my payment.
DRAFT PAYMENT TYPE *

CHECKING SAVINGS VISA / MASTERCARD DISCOVER / AMERICAN EXPRESS
EXPIRATION DATE: *
mm / yy
ACCOUNT #: *
DRAFT ACCOUNT INFO
Signature *

Clear
TOTAL BODY GYM INFORMATION PAGE - Print or Download for your records
Should be Empty:

Now create your own JotForm - It's free! Create your own JotForm

Total Body Gym Membership Enrollment

MEMBERSHIP REGISTRATION

MEMBERSHIP AGREEMENT & INFORMATION

ELECTRONIC FUNDS TRANSFER (EFT) AUTHORIZATION AND ACCEPTANCE