Membership Agreement
Capistrano Boxing Gym - New Membership Form
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First Name (Member) *
Last Name (Member) *
Date of Birth (Member) *
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DD
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YYYY
Legal Guardian Name (If Member is under 18)
Cell Phone Number *
Email Address *
Membership Plan *
Credit Card *
Card Number *
Expiration Date *
V-Code (3-digit code) *
Exact Name as it appears on the card *
Credit Card Billing Street Address *
Credit Card Billing City, State, & Zip Code *
Card Holder Phone Number *
Card Holder Authorization Signature:  By typing your name, you hereby authorize Capistrano Boxing Gym to auto deduct membership fees in set amount as selected above. Membership fees are charged on the 1st of each month.  There will be a $25 fee for all non-sufficient funds (Failed Payments). Capistrano boxing Gym is not responsible of any credit card or bank fees. *
CANCELATION POLICY: In order to cancel your membership, written notice must be provided a minimum of 10 days prior to your next billing cycle. Notification s can be submitted via email to info@capistranoboxinggym.com.  There are no refunds on any cancellations made prior to the 10 day notice. *
Required
NEW MEMBERSHIP INITIAION FEE:   *
Card Holder Authorization Signature:  By typing your name, you hereby authorize Capistrano Boxing Gym to charge the New Member Initiation Fee, along with the remaining days of the current month (pro-rated).  This is a one time charge to cover the current month (from join date) along with the new membership initiation fee.  All future charges will take place on the 1st of each month per selected membership plan. *
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