TFC Three Springs Road Athletic Center: Limited Plus

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?

Emergency Contact

Name

Phone

Birth Date

Gender

Male Female Other

Source

Drivers License # (if underage use primarys DL#)

Monthly 16th Payment

$21.15

Amount Due Today

$42.35

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Enrollment Fee	$39.95	$0.00	$0.00	0
Recurring Dues	$0.00	$19.95	$19.95	0
Sub-Total	$39.95	$19.95
Tax	$2.40	$1.20
Total	$42.35	$21.15

First Monthly 16th Payment Date: 5/16/2024

Payments will then be processed on a Monthly 16th basis there after.

Other Fee Information

Annual Facility Improvement Fee (Total) of $39.95 will be billed on a Yearly basis starting 2/1/2025

Payment Info

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TFC Three Springs Road Athletic Center: Limited Plus

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

Monthly 16th Payment

Amount Due Today

First Monthly 16th Payment Date: 5/16/2024

Other Fee Information

Payment Info

Payment Info

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