Read New Member Registration Form Template.xls text version

New Member Registration Form

Personal Information ** Please consult your Physician before beginning any exercise program** YOU MUST COMPLETE A WAIVER FORM PRIOR TO TAKING PART IN ANY CLASS OFFERED AT THE STRENGTH STUDIO, LLC Name: Last Address: Number City Telephone Number: Email Address: How did you hear about us? Did someone refer you? If so, who? Membership Type (Check One): Six Month Membership @ One Month Membership @ One Class @ Billing Information Use the same information as above for credit card billing information Name: Last Address: Number Street City Visa State Other: Zip First Middle per month for one month per class Street State Zip First Middle

Choose Method of Payment (circle one): Mastercard Card Number: (16 digit card number): Expiration Date: month year

New Member Registration Form Template.xls

Monthly Dues Billing Information - TO BE COMPLETED BY THE STRENGTH STUDIO, LLC

Your membership commences on Your membership expires on Your account will be charged a one time registration fee of at the time of initial enrollment

A $15.00 charge will be applied for each month your monthly dues are returned as uncollectible.

Please complete for members with six (6) month commitment

Your account will be billed on or shortly following the 3rd day of the month in the amount of beginning on Monthly dues prorate billed upon enrollment Prorated amount: $

$

In order to change the billing account for day 3 of the month The Strength Studio, LLC requires the change by the 25th day of the prior month. Once the six (6) month minimum term has been met, your membership will continue on a monthly basis.

The Strength Studio, LLC is not designed to be used by participants prior to receiving clearance from their health care provider. Instructions and advice are not intended as a substitute for medical counseling. The owners, instructors, and participants of The Strength Studio, LLC reserve the right to make changes to its policies, program, and schedule at any time. Signature on this form states that the participant has read and agrees to the above terms and assumes full responsibility for themselves. Please provide your signature below acknowledging you have reviewed and understand the information above.

Signature

Date

New Member Registration Form Template.xls

Information

New Member Registration Form Template.xls

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