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Adult Clinic Registration:
First Name
Last Name
Email
Phone
Member of the club? (members have 5% discount)
YES
NO
Men Package below:
1x per week $ 150 monthly
2x per week $285 monthly
3x per week $428 monthly
4x per week $570 monthly
Women Package below:
1x per week $ 150 monthly
2x per week $285 monthly
3x per week $428 monthly
4x per week $570 monthly
Additional notes
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