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MEMBERSHIP AGREEMENTMembership Agreement • September 9th, 2019
Name of Member Gillian Rush Email BringMeMyHorizon3@hotmail.com Home Phone Address16941 Friesian Drive CitySurrey ProvinceBC Postal CodeV3S 8P2 Cell Phone(604) 710 - 8772 Birth Date May 6, 1997 Gender Female ID # 0215413 Sponsor/Source Corporate Outreach In Case of Emergency Contact Carole Reed Emergency Phone # (604) 765 - 9824 MEMBERSHIP TYPE BILL TYPE EXPIRY DATE PAYMENT Club16 Regular ENROLLMENT FEE $9.00 MEMBERSHIP START DATE ROUTING NUMBER PRO-RATED PAYMENT $0.00 September 16, 2019 SECURITY CARD $20.00 MINIMUM TERM OF MEMBERSHIP ACCOUNT NUMBER ACCOUNT HOLDER NAME PRICE FOR LIFE $0.00 1 Months SUBTOTAL $20.00 BI-WEEKLY DUES PRICE FOR LIFE APPLICABLE TAXES $1.45 Payment of $8.00 is due Wednesdays on a Bi-weekly basis commencing September 25, 2019 and having an anniversary date of October 25, 2019. By initialing here I accept a onetime membership insurance to freeze my current bi-weekly membership rates as long as I keep this Club16 membership active and in good standin
