FULL NAME:

Roger Taylor

ADDRESS:

498 Montgomery Road, Raleigh, NC

HOME PHONE:

555-9483

E-MAIL:

tayrog@regumail.com

FAMILY MEMBERS:

(If applicable)

Karla Taylor (wife), Greg Taylor (son)

TYPE OF MEMBERSHIP:

(Select one)

Premium Membership: Daily access to all workout facilities and equipment, including the pool, as well as reserved lockers and dressing rooms. Includes all aerobics, spinning, dance, pilates, yoga, and meditation courses offered by the club.

□ Single 12-month package, $877

□ Family 12-month package (up to four members), $1233

Basic Membership: Daily access to all workout facilities and equipment, excluding the pool. Use of shared lockers and dressing rooms. Aerobics, spinning, dance, pilates, yoga, and meditation courses available for additional fees.

□ Single 12-month package, $722

☒ Family 12-month package (up to four members), $988

PAYMENT INFORMATION:

Payment can be remitted cash, credit card, or debit card at Raleigh Regional Sports Club's service counter. The club also requires a security deposit of $120 for each package purchased, which will be refunded upon termination of the agreement and carried over in the case of renewal. A printed receipt can be provided upon payment, or an electronic one can be sent by e-mail to the address you have indicated above.