Bainbridge Island Recreation Center: Individual Non-Resident

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

Monthly Payment

$112.37

$313.27

Service	Down Payment	Recurring	Rollover	Visits
Member 1
Basic Class	$0.00	$0.00	$0.00	0
Individual Monthly Dues	$199.00	$103.00	$0.00	0
Prorated Dues	$88.14			0
Sub-Total	$287.14	$103.00
Tax	$26.13	$9.37
Total	$313.27	$112.37

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

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