Checkout Conoco Fam – The Alaska Club

CONOCO PHILLIPS SPECIAL OFFER

First Name *

Last Name *

Phone *

Email *

Mailing Address *

Mailing Address

Street Address

Mailing Address

City

State/Province

Zip/Postal

Date Of Birth

Gender

Marital Status

Emergency Contact Name *

Emergency Contact # *

Monthly Dues (Free gold level access until July 1st 2024)

Fitness Consultation

Confirm Membership Plus Offer

I would like to signup for 2 FREE months of Membership Plus

Agree To Membership Plus Terms

I understand that my free membership plus will last 2 months. If I would like to cancel my free membership plus I must contact membership accounting. If membership plus is not cancelled at 2 months I will be charged an additional $38 starting 09/01/25. This membership plus upgrade will be billed ongoing until membership accounting is contacted.

Membership Plus Expiration Date

Add Additional Membership Plus User

I would like to signup another user for 2 FREE months of Membership Plus

I Agree To Terms

Additional membership plus user will have the same trial period as primary member. Second user will be charged an additional $20 starting on date listed above until membership plus trial is cancelled. This is in addition to the $38 fee for primary.

Agree To Membership Terms

I understand that I will receive free membership dues until July 1st. If membership trial isn't cancelled by June 21st I will be billed monthly via ACH or Credit card listed on application. To Cancel my free membership trial, I must contact membership accounting prior to June 21st, 2024. If membership trial isn't cancelled by date listed, membership will continue at Month-to-Month Terms with 60 day written notice to cancel.

Do You Have Dependents?

Yes

ADDITIONAL APPLICANT INFORMATION

CO-APPLICANT

FIRST DEPENDENT ON MEMBERSHIP

Dependent First Name

Dependent Last Name

Relationship to Applicant

Date Of Birth

Gender

Add A Second Dependent?

Yes

SECOND DEPENDENT ON MEMBERSHIP

Dependent First Name

Dependent Last Name

Relationship to Applicant

Date Of Birth

Gender

Add Third Dependent?

Yes

THIRD DEPENDENT ON MEMBERSHIP

Dependent First Name

Dependent Last Name

Relationship to Applicant

Date Of Birth

Gender

Add A Fourth Dependent?

Yes

FOURTH DEPENDENT ON MEMBERSHIP

Dependent First Name

Dependent Last Name

Relationship to Applicant

Date Of Birth

Gender

Your Fitness. Your Way

CONOCO PHILLIPS SPECIAL OFFER

ADDITIONAL APPLICANT INFORMATION arrowup6

CO-APPLICANT arrowup6

FIRST DEPENDENT ON MEMBERSHIP

SECOND DEPENDENT ON MEMBERSHIP

THIRD DEPENDENT ON MEMBERSHIP

FOURTH DEPENDENT ON MEMBERSHIP

ADDITIONAL APPLICANT INFORMATION

CO-APPLICANT