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Just Fitness 24/7

511 Lake Rd., Suite 100

Belton 254.939.3323

TXT 254.654.5166

Membership Request, Insurance Billed

Tivity or Ashlink are the only two we accept. Please allow 24 hours for verification.

First name*

Last name*

Email*

Phone*

Birthday*

Month

Day

Year

Address*

City Zip*

Membership Type*

Approved Insurance Program (One Time $10 fob fee)$10

Insurance ID Number*

Insurance Program Name*

Liability Release

Photo of Primary Account Holder *

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