Vermont Sport & Fitness Club: Couple Tennis Membership

Primary Member Information

First Name

M.I.

Last Name

Address 1

Address 2

City

State / Province

Zip / Postal Code

Home Phone

OK to Contact Home Phone

Preferred Phone

Home

OK to Contact Email?

Add-Ons for this member

Monthly Locker Rental

$6.00 down $6.00 / month

Monthly 1st Payment

$212.93

$142.82

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Monthly Adult	$0.00	$199.00	$0.00	0
Monthly Adult	$78.48			0
Startup Fee	$55.00	$0.00	$0.00	0
Sub-Total	$133.48	$199.00
Tax	$9.34	$13.93
Total	$142.82	$212.93

Payments will then be processed on a Monthly 1st basis there after.

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