Promenade: $1 a Day Gym Only

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

Add-Ons for this member

Locker Rental

$0.00 down $5.00 / every 2 weeks

WFCC Connect

$0.00 down $5.00 / every 2 weeks

Bi-Weekly Payment

$15.76

Amount Due Today

$99.33

Service	Down Payment	Recurring	Rollover	Visits
Member 1
General Facility	$0.00	$13.95	$13.95	0
General Facility	$10.00			0
Activation	$50.00	$0.00	$0.00	0
Program Orientation #1	$0.00	$0.00	$0.00	1
Consult	$0.00	$0.00	$0.00	1
Last Month Deposit	$27.90	$0.00	$0.00	0
Sub-Total	$87.90	$13.95
Tax	$11.43	$1.81
Total	$99.33	$15.76

First Bi-Weekly Payment Date: 4/30/2024

Payments will then be processed on a Bi-Weekly basis there after.

Other Fee Information

Admin Fee (Total) of $35.00 will be billed on a Annual basis starting 5/20/2024

Payment Info

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Promenade: $1 a Day Gym Only

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

Bi-Weekly Payment

Amount Due Today

First Bi-Weekly Payment Date: 4/30/2024

Other Fee Information

Payment Info

Payment Info

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