Iron Hero's Delta Gym Membership
Member Name
*
First Name
Last Name
Email
*
example@example.com
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Phone Number
*
-
Area Code
Phone Number
Emergency Contact Information
Name
*
First Name
Last Name
Phone Number
*
-
Area Code
Phone Number
Todays Date
*
Membership Monthly Payment (Mandatory 12 month agreement)
*
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Standard Membership
$
35.00
Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
Hero Discount Membership
$
30.00
For active and retired police firefighters, and EMS. Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
Active Military and Veterans
$
25.00
For Active Military and Veterans Only Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
Student Athlete (13-18 yrs old)
$
20.00
3 month commitment. Ages 13-18 years old that are still in middle/high school. Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
Age
13
14
15
16
17
18
Graduation Year
2024
2025
2026
2027
2028
2029
2030
PrePay Standard Membership Annual Payment (10% Savings)
$
378.00
This includes all 12 months of the membership and then will roll over month-to-month. This does NOT include the semi-annual maintenance fees. Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
PrePay Hero (EMS, Police, Firefighter) Membership Annual Payment (10% Savings)
$
324.00
This includes all 12 months of the membership and then will roll over month-to-month. This does NOT include the semi-annual maintenance fees. Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
College Break Rate
$
40.00
For college students home for school break. No Contract with this.Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
PrePay Active Military or Veteran Membership Annual Payment (10% savings)
$
270.00
This includes all 12 months of the membership and then will roll over month-to-month. This does NOT include the semi-annual maintenance fees. Please call or text (419) 407-6571 to schedule your keyfob pick-up. **Only one membership submission per form please**
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Subtotal
$
0.00
Tax
$
0.00
Total
$
0.00
Credit Card Details
First Name
Last Name
Credit Card Number
Security Code
Card Expiration
*Hero Membership discount applies only to Military/Vets/EMS/Firefighter/Police Members
What Group Applies to You ex. Police Officer
Upload Your Hero ID or DD214 for Hero Membership Discount Members Only
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