Choose Color Theme:
orange green violet red white

Latest News

Membership Registration

Submit Online Application
Member Type *
Grand Patron - $5000 Patron - $1000 Life - $50 ($100)
     
First Name : *
 Last Name : *
 M I :
Profession :
 Email Id : *
Address 1 : *
 Address 2 :
City : *
 State : *
 Zip : *
Home Phone :
 Mobile Phone : *
Fax :
 Website Address :
Would you like to register for ATA Discounted LA Fitness Membership *
Marital Status *
Spouse First Name : *
 Spouse Last Name : *
Spouse Mobile :
 Spouse Email : *

Name of the children Relation

Additional Info/Comments :
Referred By : (If no one referred, enter "Self") *
If you enter a coupon code, you must click the apply button
Coupon Code :

Payment Details
Card Type *
Card Holder Name *
Card Number *
Exp. Date * (mm/yyyy)
CVN * CVN
 
Securtity Captcha:* 
4 + 13 =
  I agree to the terms and conditions.
 
 
top