CVAC - Chagrin Valley Athletic Club

Chagrin Valley Athletic Club
Snyder Rd. & E. Washington St.
P.O. Box 23338
Chagrin Falls, OH 44023-0338
(440) 543-5141

Membership Application

All fields marked with a * must be completed for form to process correctly

Your Name*
Birth Date*
SSN*

Spouse Name
Birth Date
SSN

Child
Birth Date
Age

Child
Birth Date
Age

Child
Birth Date
Age

Home Address*
Home Phone*
Business Phone*
Business Affiliation*
Title
Business Address*
City*
State*	ZIP *

Bank or Financial Insitution*
Credit Cards or Charge Accounts*
Present Club Affiliations
How did you hear of us?
CVAC members you know
Date*
E-mail Address*

By submitting this form the applicant hereby acknowledges that he/she has read a copy of the Rules and Regulations of Chagrin Valley Athletic Club, Inc. as in effect on the date hereof. The applicant acknowledges that, as a member, he/she is required to abide by and is bound by the terms of the Rules and Regulations and that the Rules and Regulations may be amended or modified from time to time in accordance with the provisions thereof and applicable law. I/we understand and agree that any credit granted shall be payed promptly in accordance with terms and agreements, that the credit grantor may add one and one half percent (1 1/2%) per month to any balance owed, and in the event of default to pay reasonable collection charges and/or attorney fees.

If you have questions, comments or suggestions regarding this website, contact CVAC