LA Fitness Membership Request Form

Information

Please complete and submit this form to request a discounted LA Fitness Membership. Your voucher number(s) and instructions on how to complete your enrollment will be emailed to you, usually in about one business day. To review membership levels, see below or visit the Alumni Benefits page at: www.westernu.edu/alumni/alumnibenefits/. If you have any questions, please contact the Alumni Office at alumni@westernu.edu or (909) 469-ALUM.

Membership Details:

Save on annual memberships at L.A. Fitness clubs located throughout the United States with these special WesternU rates:

Single State Paid in Full - $299.00 paid in full for 12 months of access. Grants access to all LA Fitness and Esporta clubs within the state of enrollment, excluding signature clubs.

Signature Paid in Full - $359.00 paid in full for 12 months of access. Grants access to all LA Fitness and Esporta clubs in the US and Canada.

Single State Monthly - $0 initiation / $29.99 monthly dues / $49.00 annual fee. Grants access to all LA Fitness and Esporta clubs within the state of enrollment, excluding signature clubs.

Signature Monthly - $0 initiation / $34.99 monthly dues / $49.00 annual fee. Grants access to all LA Fitness and Esporta clubs in the US and Canada.

Personal Information

First Name*

Last Name*

Name at Graduation (if different)

Degree*

Class Year*

Preferred Email*

Preferred Phone Number

Preferred Phone Type

Address Line 1

Address Line 2

City

State

ZIP Code

LA Fitness Memberships

Membership Level*

Family Memberships

Alumni may enroll up to five family members residing at the same address. Please feel out the fields below with your family names and voucher choices.

Family Member 1 Name

Family Member 1 Voucher Choice

Family Member 2 Name

Family Member 2 Voucher Choice

Family Member 3 Name

Family Member 3 Voucher Choice

Family Member 4 Name

Family Member 4 Voucher Choice

Family Member 5 Name

Family Member 5 Voucher Choice

LA Fitness Membership Request Form

Membership Details:

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