Common Contracts
1 similar Membership Registration Agreement contracts
MEMBERSHIP REGISTRATION FORM & AGREEMENTMembership Registration Agreement • June 19th, 2020
PRIMARY ADULT Legal First Name Middle Initial Legal Last Name Date of Birth❑ Male ❑ Female Home Address City State ZIP For Office Use Only: CDL VFY: Primary Adult Other Adult Dependent Adult Home Phone Cell Phone Cell Carrier❑ Check here to receive text message updates Emergency Contact Name (Required. Must be outside of household) Emergency Contact Phone Relationship PRIMARY ACCOUNT HOLDER E-MAIL ADDRESS (SERVES AS YOUR Y ACCOUNT LOGIN)Email (Thank you for agreeing to receive our periodic email communications. We never share or sell email addresses.) OTHER ADULT Legal First Name Middle Initial Legal Last Name Date of Birth❑ Male ❑ Female Home Phone Cell Phone Cell Carrier❑ Check here to receive text message updates Secondary Email (For communication purposes only. Thank you for agreeing to receive our periodic email communications. We never share or sell email addresses.) DEPENDENT Legal First Name M.I. Legal Last Name Relationship to Primary Date of Birth (mm/dd/yy)❑ Male ❑ Female
