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Free Trial Week Date: _______-_________ Where did you hear about us?

__________________________ Member Name: __________________________________________! !

Date of Birth: __________________ Address: ________________________________ City: _______________ State: ____ Zip: ______ Home Phone: _____________ Cell Phone: ____________ Social Security #: ________________ Email Address: ______________________ Are you on Facebook? __________________________ Emergency Contact Name: __________________________ Phone: _________________________ Type of Membership: 1 Year MMA $90.00./Month 1 Year Cardio $30.00/Month Paid in Full _______________ Kids Class $75.00/month Other: ___________________

Total Due Today: $ ____________ Received (circle one): YES NO Method of Payment: _____________________ First payment date: ______________________ Membership Terms: Member has applied for a ________________ membership. In consideration thereof and notwithstanding any other terms and conditions of this agreement. Member shall be liable for dues and services for the full term of this agreement in the amount as stated herein regardless of usage, unless he/she moves 25 miles from current business or residence. Verification of such move must be provided in writing 30 days prior to effective date of cancellation. After the initial term, membership has expired, this agreement shall automatically continue from month to month at the prevailing rate which is subject to change until 30 days written notice is provided to Red Nose MMA. ____ (initial) EFT/ACH Authorization: I authorize Fit or Fight to initiate a charge for my dues and purchases to the bank account or credit card indicated above. The monthly dues will be charged (circle one) monthly biweekly at a rate of $_______. This authorization is to remain effective until Fit or Fight has collected for all charges assessed in connection with the terms and conditions of this agreement. I have the right to stop payment on automatic debit by notifying my bank. This however does not void my contract with Fit or Fight to fulfill my payment commitment and I am obligated to pay by some other method. ___ (initial) Cancellation and Refund Policy: All members are entitled to terminate this agreement via written notice of resignation received by the manager or owner within three (3) days of making this agreement. ___ (initial)

Returned Payments & Published Fees: Any payment made that is returned or is uncollectible will be assessed a returned item charge of $25. All member fees are subject to change at the discretion of Fit or Fight except for prepaid membership fees which are not subject to change until the expiration of the current contract. ___ (initial) Collection of Fees: Members will be liable for any collections fees, reasonable attorney fees, court costs and all other expenses incurred by Fit or Fight in collecting an overdue account. Any member whose account remains unpaid thirty (30) days after the date charged may at the discretion of Fit or Fight have their membership privileges terminated. ___ (initial) Policies: Member agrees to conform to and be bound by the policies of Fit or Fight as they may be amended from time to time. Membership does not confer any ownership of Fit or Fight property or assets. Fit or Fight reserves the tight to terminate this agreement at any time, with or without notice, and will refund any unused portion of prepaid fees collected on behalf of this agreement. Memberships may not be shared and all guest must have a pre-authorized card to enter. Failure to abide by this policy shall result in immediate termination of membership without refund. ___ (initial) Membership Transfers: Member may transfer his or her membership to another qualified person by paying a $50 transfer fee to the complex. ___ (initial) Liability Waiver: All exercise and participation is done at the risk of the member and his/her guest and Fit or Fight is not liable for theft, lost of personal property or injury including bodily injury or death. Member acknowledges that Fit or Fight will bot accept responsibility for theft or damage to any personal property. Fit or Fight suggests that the member not bring valuables onto the gym’s premises. In consideration of membership agreement, member hereby assumes all risks associated with the use of Fit or Fight facilities and waives all rights and rights of guests, heirs, administration, executors, successors and assigns and hereby agree to release the operators, building owner, building manager, and any of their affiliated and Fit or Fight from and indemnify such parties against any and all claims, including but not limited to personal injury including bodily injury or death and all property damage whether or not based on the acts or omission of Fit or Fight arising out of or in any way connected with the use of the Fit or Fight facility by member. Any party benefited by the terms of this liability waiver shall be entitled to rely on and enforce such terms. The name of the complex may change for business reason and will not at all release or amend a member’s obligations under this agreement. The terms and conditions contained herein along with the policies constitute the full agreement between Fit or Fight and the member and no oral promises made are part of it. ___ (initial) I accept all the terms and conditions set forth in the agreement and have received a copy of this contract. ___ (initial) NOTES: ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________ ________________________________________________________________________________________________________________________

Applicant Signature: _____________________________________ Applicant Name Printed: _____________________________________ Fit or Fight Representative: __________________________________ 208 Meramec Station Rd ! Valley Park, MO 63088 ! ! ! ! ! !

Date: ____________________

Date: ____________________ AAC (processing company) 1-800-233-8483 314-933-0065 ! !