Special Membership Form

First & Last Name *

Place of Work/Education *

Cell Phone Number *

Email Address *

Please select your membership: *

Home Studio *

Please Confirm Charge: *

Check here to confirm that you have a Body Alive account and authorize Body Alive to charge your credit card on file for the amount of your selected promotional option above (plus 6% sales tax for Kentucky members). If you do not have a Body Alive account, you can create one by clicking "Login" in the upper right corner.
Check here to acknowledge that you will not create multiple accounts with the intent to deceive or to obtain promotions for which you would not otherwise qualify.

Terms and Conditions *

Check here to indicate that you have read and agree to the terms and conditions of service.

Please upload a photo of your driver's license or identification card. *

Click or drag a file to this area to upload.

ID is required to confirm account eligibility for promotions.

Back to City