1550 22ND ST
WEST DES MOINES, IA 50266
515-225-9900
 

      Membership Type: MONTH TO MONTH
       
      Processing Fee: $20.00
       
      Enrollment Fee: $1.00
       
      First Months Dues: $34.99
       
      Total Due Today: $55.99
       
 M E M B E R   I N F O R M A T I O N
   
 First Name   MI  
 Last Name
 Address 1
 Address 2
 City   St  
 Zip
 Birthday
   
   
Home Phone
Cell Phone
Work Phone
E-Mail
Confirm E-Mail
Company Name
Referred By (Member #)
   
 M E M B E R   B I L L I N G   I N F O R M A T I O N
 Monthly Recurring Billing Information  
   
 How would you like to pay for your monthly dues?
 I want to use my credit card.
 I want to use my bank account.
 Enrollment Billing Information  
   
 Credit Card Number
 Expiration Month
 Expiration Year
   


 B I L L I N G   F O R   M E M B E R S H I P
   
  NOTICE OF DUES RENEWAL: This Member Agreement (this `Agreement`) will renew automatically on a month-to-month basis, with monthly dues to be paid in the amount equal to the dues in effect at that date. Golds Gym reserves the right to change the amount of dues and charges payable hereunder at anytime. Member may cancel this Agreement at any by sending a 60-day written notice prior to the monthly dues date to Golds Gym complying with the provisions set forth in the Membership Terms section of this page. Cancellation shall be effective in 30 days, which includes one billing cycle from receipt of notice.
  RATE GUARANTEE FEE: By checking this box, I agree to a once-a-year fee of $35.00 billed approximately 120 days from the membership join date, to the billing account on file.
  I wish to make my payments to Golds Gym through its Pre-Authorization Payment Program. I hereby authorize my bank or credit card company to make my payment for monthly dues, any unpaid past dues, and and other fees, taxes or charges from the account I used to pay for the Total Due Today or from the account shown above. Your account will be billed on or around the 1st day of the month until you cancel in accordance with this Agreement. I agree to pay a service fee of $10.00 as well as any other charges allowed by law for any EFT or credit card charge not honored by my bank or credit card company. I understand that Golds Gym may, upon written notice, change the date that my monthly dues are debited from my account.
   
 M E M B E R S H I P   T E R M S
 
 I have read the membership terms and accept them