Support – WPForms

Name

First

Last

Gender

Birthdate

Contact Email

Contact Phone

Address

Address Line 1

Address Line 2

City

State

Zip Code

Name

First

Last

Emergency Phone

Relationship to Member

Membership Type

Name Contact Email

Reasons for Joining the Club

Referred By (if applicable)

First

Last

I have carefully read the preceding and understand its terms. I understand that I am giving up substantial rights, including my right to sue Releasees as set forth above. I acknowledge that I am signing this Agreement freely and voluntarily. I intend my electronic or handwritten signature to be a complete and unconditional release of all liability to the greatest extent permitted by law.

Signature

Clear Signature

Agreement

I have read and agree to the club rules and code of conduct. I understand that failure to follow club rules may result in termination from the club.

Date of Application

Credit Card