Name: | ________________________________________________ | Partner: | ________________________________________________ |
Email: | ________________________________________________ | Email: | ________________________________________________ |
Phone: | __________________________ Birthday: ____/____/____ | Phone: | __________________________ Birthday: ____/____/____ |
Street: | ________________________________________________ | Street: | ________________________________________________ |
City: | _______________________ State: _____ Zip: __________ | City: | _______________________ State: _____ Zip: __________ |
Please check type of | |||||||||||||||||
Membership desired: | ☐ Single | ☐ Couple$24 – July, $22 - August, $20 - September | $36 – July, $33 - August, $30 - September | Prorated $2/$3 a month | $18 October, $16 November | $27 October, $24 November | $14 December, $12 January | $21 December, $18 January | $10 February, $8 March | $15 February, $12 March | May/June include next year | $6 April, $28 May, $26 June | $9 April, $42 May, $39 June | |