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Iron Attic 24-hour Fitness ~ Membership Card

Today’s Date: _____________________ Card #: _____________________

Name: ___________________________________________ DOB: ______/______/________

Address: _____________________________________ City: _______________ Zip:_________

Email: ___________________________________________________________________________________

Mobile: ____________________________________ Other Phone: ______________________________ May we contact you via Text? YES or NO

Emergency Contact: Name: ________________________________________ Phone: __________________

Type of Membership: Renewal Date: ___________________________________ (Staff fill-in)

Iron Attic 24-hour Fitness ~ Membership Card Today’s Date: _____________________ Card #: _____________________

Name: ___________________________________________ DOB: ______/______/________

Address: _____________________________________ City: _______________ Zip:_________

Email: ___________________________________________________________________________________

Mobile: ____________________________________ Other Phone: ______________________________ May we contact you via Text? YES or NO

Emergency Contact: Name: ________________________________________ Phone: __________________

Type of Membership: Renewal Date: ___________________________________ (Staff fill-in)

Employer: _________________________________________________ Phone: __________________________ Do you receive insurance benefits for having a gym membership? YES or NO

Do you need a receipt? YES or NO (Preferred delivery of receipt? �MAIL or �EMAIL)

£ SingleMonthly -EFTcontract $25£ SingleMonthly $35£ SingleAnnual $300£ FamilyMonthly-EFTcontract $45£ FamilyMonthly $55£ FamilyAnnual $500£ CollegeAnnual(IDreq’) $150£ Discount:________________________________________

£ SingleMonthly -EFTcontract $25£ SingleMonthly $35£ SingleAnnual $300£ FamilyMonthly-EFTcontract $45£ FamilyMonthly $55£ FamilyAnnual $500£ CollegeAnnual(IDreq’) $150£ Discount:________________________________________

Employer: _________________________________________________ Phone: __________________________ Do you receive insurance benefits for having a gym membership? YES or NO

Do you need a receipt? YES or NO (Preferred delivery of receipt? �MAIL or �EMAIL)