MEMBER  REGISTRATION
 
   Membership Type: Premium Month to Month Membership
    
   Enrollment Fee: $ 25.00
    
   First Month Dues: $ 34.50
    
    
   Total Due Today: $
   
   Billing Begins: 10/28/2017
   
 PERSONAL  INFORMATION
   
     First Name / MI
     Last Name
     Address 1
     Address 2
     City / State
     Zip
     Driver License #
   
   
Birthday
Home Phone
Cell Phone
E-Mail
Confirm E-Mail
Emergency Contact
Emergency Phone
Hear About us?
   
 
 BILLING  INFORMATION
 
    How would you like to pay for your monthly dues?
     I want to use my credit card.
     I want to use my bank account.
    
    How would you like to pay today?
    Credit Card Type
    Credit Card Number
    Expiration Month/Year /
   
 
 TERMS  AND  CONDITIONS
 
 I have read and AGREE to the membership terms and club rules.
 
 
Member
 
Parent/Guardian