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 Name
Last Name
Home Address
*
Street Address
Street Address Line 2
City
State / Province / Country
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date
Phone Number
*
E-mail
*
example@example.com
File Upload (Valid: ID/ DL / Passport)
*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
File Upload (Parent or Guardian Valid: ID/ DL / Passport) If applicable*
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Company Name
*
Company / Store Address
*
Street Address
Street Address Line 2
City
State / Province / Country
Postal / Zip Code
Job Tittle
*
CEO / Owner
CFO
President
Business Partner
Accountant
Assistant
Picker
Other
For BLACK CARD Applicants ONLY: Submit (Business License / Tax ID Form / W9 Production Companies)
Browse Files
Drag and drop files here
Choose a file
Cancel
of
Which Membership are you Interested in purchasing?
*
Black Card ($499.99)
Platinum ($199.99)
Gold ($99.99)
Silver ($49.99)
Please give 2 business references:
*
Full Name
Address
Contact Number
1
2
Please give 2 Emergency Contacts:
*
Full Name
Relationship to you
Contact Number
Person #1
Person #2
How did you hear about us?
*
Please Select
Facebook
Instagram
X
Website
Friend
Other
Search Engine
Your Prefered Method of Contact
*
Please Select
Phone Call
Text Message
Email
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.
*
I agree to sections 1-6
Disclaimer signature.
*
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