Club Fit Jefferson Valley: Program Billing Membership

1. Review Base Plan

Summary

This plan is for families participating in programs such as swimming lessons or our After School Care Program without full club access memberships. Recurring monthly program fees will be based on registration forms completed for each program enrolled in. Credit information submitted here will be kept in our database for program registration and house charging fees incurred for the family members included on this agreement. You may terminate or withdraw this authorization for us to use your stated method of payment at any time upon 45 days' written notice to us. Written notice may be provided via fax, email, or letter, or by stopping by Club Experience Department and filling out a form. Unpaid monies owed for programs, additional services or House Charges will become due and payable immediately on the date of termination. We will terminate this authorization after a period of 18 months of inactivity and require you to enter into a new Program Agreement with anew payment authorization. Please include all your immediate family members regardless of current program enrollment plans to save time processing sign ups for additional family members in the future. AUTHORIZATION FOR PROGRAM FEES/HOUSE CHARGES MY/OUR Program Agreement IS SUBJECT TO THE TERMS AND CONDITIONS ATTACHED (“TERMS”). Unless I cancel or terminate in accordance with the Terms, my program relationship will automatically remain active and my provided method of payment will be subject to auto updates as may be periodically provided by credit services. I authorize Club Fit to use my above-referenced method of payment for all fees/costs related to any and all programs and services in which I/we enroll within an 18 month period, as well as any monies owed from House Charges (as defined in the attached Terms and Conditions) during that period of time. House charges will run on the first of every month commencing on the Effective Date. I agree to pay all such charges. By completing this form I agree to the terms and conditions above and outlined after registering my financial information.

Access To Areas

General Check-in Non Member

Services

Account Registration Fee

This plan requires 1 member with a maximum of 10 members.

* This plan requires a minimum number of members including the primary member.

Monthly Payment

$0.00

Amount Due Today

$0.00


Service

Down Payment

Recurring

Rollover

Visits

Account Registration Fee $0.00 $0.00 $0.00 0
Sub-Total $0.00 $0.00
Tax $0 $0.00
Total $0.00 $0.00