Vitality Fitness

Credit Card Info Form

Click here for Printable Version Credit Card Info Form

PLEASE READ AND INITIAL EACH INDIVIDUAL ITEM

___ 1. I understand I must give a 12 hour cancellation notice for a workout to be eligible to
make-up the missed session.

___ 2. I understand if I am late for my session I will only receive the balance of the time
remaining.

___ 3. I understand when I am not with a trainer I am only allowed to use the cardiovascular
equipment. This is to keep a private one on one setting and not a gym setting.

___ 4. I understand I may work with different trainers, only if my trainer is unavailable.

___ 5. I understand there is a no refund policy.

___ 6. I understand when I purchase a package I am purchasing a specific number of time
slots for a given month. Should I decide to quit, I understand I must give written notice
on or before the 15th of the month so I will not be billed for the next month.

Signature	Date	Trainer Signature	Date
________________________	_______	________________________	_______

Number of Sessions Per Month _________ Rate Per Session_______

CREDIT CARD INFO IS REQUIRED BEFORE YOUR TRAINING CAN COMMENCE

CARD________ CARD #_____________________________________ EXP______________

BILLING ADDRESS ___________________________ 3 or 4 DIGIT #___________

___________________________

E-MAIL FOR RECEIPT TO BE SENT _____________________________________________

SIGNATURE ____________________________________

____ I prefer for my card to be run at the beginning of the month with the receipt stapled to my invoice and put in my mailbox.
____ I would like for my card to only be used if I have an outstanding balance on the 14th of each month.