Hope Fieldhouse: Minor Individual Agreement

1. Review Base Plan

Change Plan

Monthly Payment

$32.14

Amount Due Today

$50.27

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Individual Dues	$0.00	$30.00	$0.00	0
Prorated Dues	$6.93			0
Joining Fee	$40.00	$0.00	$0.00	0
Sub-Total	$46.93	$30.00
Tax	$3.34	$2.14
Total	$50.27	$32.14

First Monthly Payment Date: 4/1/2023

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

Other Fee Information

Annual Fee (Total) of $35.00 will be billed on a Annual basis starting 5/1/2023

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