Downtown Athletic Club: Individual - Downtown

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?

Emergency Contact

Name

Phone

Birth Date

Gender

Male Female Other

Monthly Payment

$66.26

$25.68

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Risk free cancellation policy	$0.00	$0.00	$0.00	0
Access to DAC	$0.00	$61.00	$0.00	0
Access to DAC	$23.64			0
Sub-Total	$23.64	$61.00
Tax	$2.04	$5.26
Total	$25.68	$66.26

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

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