2023 SUMMER PACKAGE

MEMBERSHIP AGREEMENT

MEMBER INFORMATION

FIRST NAME *

LAST NAME *

PHONE NUMBER *

TYPE *

EMAIL ADDRESS *

DATE OF BIRTH * +

MAILING ADDRESS *

CITY *

STATE *

ZIP CODE *

EMERGENCY CONTACT NAME *

EMERGENCY CONTACT PHONE *

RELATIONSHIP TO MEMBER *

PLEASE SELECT AN OPTION *

BUYER INFORMATION

FIRST NAME *

LAST NAME *

PHONE NUMBER *

TYPE *

EMAIL ADDRESS *

MAILING ADDRESS *

CITY *

STATE *

ZIP CODE *

MEMBERSHIP SUMMARY

NOTICE TO MEMBER AND BUYER: DO NOT SIGN THIS AGREEMENT UNTIL YOU HAVE READ IT ENTIRELY. BY SIGNING THIS AGREEMENT YOU ACKNOWLEDGE THAT YOU HAVE READ, UNDERSTAND AND AGREE TO BE BOUND BY ALL OF ITS TERMS, INCLUDING THE ASSUMPTION OF RISK, WAIVER, RELEASE, INDEMNIFICATION, AND STANDARD TERMS, CONDITIONS, NOTICES AND DISCLOSURES, AS SET FORTH BELOW.

MEMBERSHIP TYPE:

PIF (Pre-Paid)

TRAINING CENTER ACCESS:

WLA

SHO

BASE SERVICE(S):

Krav Maga – Level Access 1

Fitness

2 Seminars

PURCHASE AMOUNT *

One Time Purchase ($499)

Total Due Now:

$0.00

Membership Term: term duration is two months from start date

Start Date: * +