Fit 4 Life of Rocky Mount Online Enrollment


Date of Birth (mm/dd/yy) *
Emergency Contact Information *
Name (First, Middle, Last)
Contact Number

Membership Packages Below

Each Members will Pay a 1 time $5.00 Fit 4 Life 24/7 Swipe Card thats good for life. 
(Replacement Key Cards are subject to a $5.00 fee)
Operating/Staffed Hours:
Monday - Friday
10am to 5:00pm
(New Members will have to come in to recieve their Keycard with valid ID during staffed hours)
Monday - Friday 10am to 5pm
1 Time Key Card Fee
(good for as long as you own it)
Single Person Memberships

Spouse Pricing
3 Person Family Member Packages 

Current Total:

Credit Card Information

Facility Improvement and Addendum: each year, every member enrolled will be required to pay a $39.00 facility improvement and service fee in addition to their normal dues. The $39.00 facility improvement and service fee will be due on November 15th. I agree to pay this fee if my membership is active on the above date, even if I choose to cancel. 
Primary Signature Below (use mouse to do so) *
Consumers Right to Cancellation. Three (3) Day Cancellation Policy
You may cancel the contract without any penalty or further obligation by providing a written notice of cancellation to be delievered in person or by certified registered mail within three (3) days of the above date on your reciept.
In attending Fit4Life and using its facilities and equipment, I agree that I am doing so at my own risk. Fit4Life shall not be liable for any damages arising from personal injuries sustained by me on the premises of Fit4Life. I assume full responsibility for any injury sustained by me on the premise. I assume full responsibility for any injuries which may occur to me on the premise of Fit4Life and I release and discharge Fit4Life, its owners, employees, and agents from any and all claimsresulting from my use of the facilities and equipment of Fit4Life. I represent that I am in good physical condition, and I have no disabilities or impairment preventing me from engaging in active or passive exercise that would be detrimental to my health, safety, or physical condition. I agree that I am responsible for any damage caused by me to the facilities and equipment of Fit4Life.
 At end of agreement contract will continue on a monthly basis until notification in writing or cancellation form is filled out.
Must give 30 days notice upon cancellation. 
Cancellation Cause: If you move more than twenty (20) miles you may cancel your membership after providing proof of such move, I.E. Utlility Bills, upon payment of a 2 month membership fee or a $50.00 cancellation fee, whichever is greater. 
Fit4Life memberships are not transferrable to any other Fit4Life. 
Fit4Life of Rocky Mount is Independently Owned and Operated
3020 Sunset Avenue
Rocky Mount, NC 27804
Powered byFormsiteReport abuse
Secured by Formsite