Wilson's On Rangeline: 09. All Fitness Monthly

Primary Member Information

First Name

M.I.

Last Name

Address 1

Address 2

City

State / Province

Zip / Postal Code

Home Phone

Mobile Phone

OK to Contact Home Phone

OK to Contact Mobile Phone

Preferred Phone

Home

Mobile

OK to Contact Email?

Birth Date

Source

Add-Ons for this member

Class Pass

$0.00 down $35.00 / month

PT MAP Move Assess Plan

$149.00 down $0.00 / month

PT Boost

$49.00 down $0.00 / month

Monthly 7th Payment

$70.13

$137.17

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Capital Improvement Fee	$50.00	$0.00	$0.00	0
All Fitness EFT	$0.00	$64.95	$0.00	0
All Fitness EFT	$77.04			0
Sub-Total	$127.04	$64.95
Tax	$10.13	$5.18
Total	$137.17	$70.13

Payments will then be processed on a Monthly 7th basis there after.

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