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Membership Agreement

Gender MaleFemale

Birth Date

Gym Membership (check box below) or No Gym Membership

Gym Membership

One Year Term via Monthly EFT/CC

PrePay - 12m

PrePay - 3m

PrePay - 1m

Month to Month via Monthly EFT/CC

Month to Month

SilverSneakers

Prime

Silver&Fit

GlobalFit

PrePay Dates: Begins Ends

Leave this empty:

Your legal name

Please Confirm full name and signature.

Draw your signature with your mouse, tablet or smartphone Clear

I agree that I am and I agree this is a legal representation of my signature for all purposes just the same as a pen-and-paper signature

I agree that I am and I understand this is a legal representation of my signature

Timestamp

Audit

February 19, 2019 6:46 pm CDT

Membership Agreement Uploaded by Josh Hightower - support@titanfitnessonline.com IP 24.155.45.105