Membership Change Form

Membership or Key Tag #*
This is the barcode number that appears on the card you use to check-in. If you do not have this number you must come into the club to complete your request.
Billing Change
- I would like to update my billing or credit card information
Please do not submit credit card details on this form. A member of our team will call you to update your information.
Name*
First Middle Last
Address*
Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country
Email*
Birth Date*
MM slash DD slash YYYY
Cell Phone
Home Phone*
Work Phone
Emergency Contact Name*
First Last
Emergency Contact Phone*
Consent*
I agree
I (the member), hereby authorize World Gym to initiate the above changes to my membership account. This form serves as an addendum to your (the member’s) contract with this health club. I understand that I must give World Gym a 31 day notice to validate any changes requested. The changes made herein are binding under the terms of the original membership agreement.
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