Payne's Gym: Family Contract w rollover

This plan requires 3 members with a maximum of 10 members.

How many total members would you like on this plan?

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

(1) 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

Gender

Male Female Other

Source

Monthly 3rd Payment

$48.70

Amount Due Today

$228.05

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Startup Fee	$159.99	$0.00	$0.00	0
Membership Dues	$0.00	$44.99	$44.99	0
Prorated Dues	$44.40			0
Key Fob	$20.00	$0.00	$0.00	0
Sub-Total	$224.39	$44.99
Tax	$3.66	$3.71
Total	$228.05	$48.70

First Monthly 3rd Payment Date: 6/3/2024

Payments will then be processed on a Monthly 3rd basis there after.

Other Fee Information

Annual Upkeep Fee (Total) of $85.00 will be billed on a Annual basis starting 7/17/2024

Payment Info

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Payne's Gym: Family Contract w rollover

This plan requires 3 members with a maximum of 10 members.

Monthly 3rd Payment

Amount Due Today

First Monthly 3rd Payment Date: 6/3/2024

Other Fee Information

Payment Info

Payment Info

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