20130311 Potomac & Patriot CrossFit Pricing Updates

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This form provides Potomac and Patriot staff with the required information to update your membership based on your requirements. Please see the policies associated with these Pricing Updates in the provided power point presentation prior to doing this survey.

Last Name *

First Name *

Security Question: Which email do we send your monthly membership receipt to? *

Security Question: Is Brian the best looking coach at PCF?

Yes

Clear selection

Your membership is good at both gyms. Potomac will require class sign ups ahead of time and no dropping. Patriot will remain "Just show up". Which box will you go to most of the time?

Just guess, this is just a survey question.

Potomac

Patriot

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Would you like to do a Buy or Contract?

This gets charged based on whatever price you are currently paying based on when you joined PCF.

3 Month Contract (2.5% Discount).

6 Month Contract (5% Discount).

3 Month Up Front Buy (7.5% Discount).

6 Month Up Front Buy (10% Discount).

12 Month Up Front Buy (15% Discount, Free Group Foundations Slot).

No commitment, month-to-month contract (0% Discount).

Clear selection

When would you like your contract or buy to take affect?

Select one of the three or enter a specific date. Earliest we can get it done is your first billing cycle after April 1. Last day to select for purchase is June 1.

My next billing cycle

One month after my next billing cycle

End of your current buy

Other:

Clear selection

What level of Membership, Contract, or Buy do you want?

This gets charged based on whatever price tier there is based on when you joined PCF.

9x/Month

13x/Month

Unlimited

Clear selection

If you are currently paying with credit card, you can switch to ACH and save 5%. We are going to need your bank account information in order to do automatic withdrawals from your bank account (commonly known as ACH transactions, Automated Clearing House). What is the full name on your bank account?

What is your bank routhing number? (9 Digits)

What is your bank account number?

What type of account is this?

Checking

Savings

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Submit

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