MEMBER  REGISTRATION
 
   Membership Type:    Student, Senior, Military 3 Month Prepaid Membership
   Enrollment Fee:    $ 139.00
   Total Due Today:    $ 139.00
 
 PERSONAL  INFORMATION
   
     First Name / MI
     Last Name
     Address 1
     Address 2
     City / State
     Zip
     Birthday
   
   
Home Phone
Cell Phone
E-Mail
Confirm E-Mail
Emergency Contact
Emergency Phone
Hear About us?
   
    
    How would you like to pay today?
    Credit Card Type
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    Expiration Month/Year /
   
 
 TERMS   AND   CONDITIONS
 
 I have read and agree to the contract terms. Click to view
 I have read and agree to the billing for membership. Click to view
 I have read and agree to the waiver of liability. Click to view
 
 
Member
 
Parent/Guardian