Membership Change

Your First Name *

Your Last Name *

Your Email Address *

Membership Changes (Please select all that apply): *

Adding a member to membership
Adding a membership add-on
Removing a membership add-on

What add-on(s) would you like to add? *

See https://www.balancefitnessoregon.com/membershipaddons for more information on each membership add-on.
See https://www.balancefitnessoregon.com/memberships for more information on pricing of add-ons and packages.

What add-on(s) would you like to remove? *

What member would you like to add to your membership? *

First

Last

What is his or her email address? *

What is his or her phone number? *

Is this member 18 or over?

Yes
No

Parent/Guardian's Name *

First

Last

Parent/Guardian's Email Address *

Add, Need to Add 1

I need to add another member to my membership.

What 2nd member would you like to add to your membership? *

First

Last

What is his or her email address? *

What is his or her phone number? *

Is this member 18 or over?

Yes
No

Parent/Guardian's Name *

First

Last

Parent/Guardian's Email Address *

Add, Need to Add 2

I need to add another member to my membership.

What 3rd member would you like to add to your membership? *

First

Last

What is his or her email address? *

What is his or her phone number? *

Is this member 18 or over?

Yes
No

Parent/Guardian's Name *

First

Last

Parent/Guardian's Email Address *

Any member addition or extra add-ons will be charged prorated for the current month, as soon as we receive this form. If you've added a member, your additional member will receive an email from DocuSign to sign his or her membership agreement. This must be signed prior to beginning exercise.

Any new members, or any extra membership add-ons, have a 3 month minimum before they can be removed.

Please confirm the last 4 digits of your current credit card on file, for verification of any membership changes. *

Signature *

Balance Fitness

Membership Change Request

Gym Hours

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