First Name___________________________________________________________
Last Name___________________________________________________________
Address_____________________________________________________________
City________________________________________________________________
State_________________________Zip/Postal Code__________________________
Country______________________________E-mail__________________________
Home Phone_______________________Work Phone________________________
Birthday______/______/______Age_________ Height_______Sex______________
Date of Application_______/_______/_______ Country_______________________
Occupation__________________________________________________________
GYM INFO.
Name_______________________________________________________
Address_____________________________________________________
City___________________________State_________________________
Zip/Postal Code__________________Country______________________
Interested in: Bodybuilding____Fitness_____Figure_____Model Search_____
Bikini Divas_____ Kids and Teens Fitness_____
Applicants Signature__________________________________________________
If Under 18 Parent's Signature__________________________________________
Applicants Signature__________________________________________________
If Under 18 Parent's Signature__________________________________________
Please Send My: ABA/INBA Membership* $60.00
***Please note, add an additional $5.00 fee for processing***
If you purchase your card between January and June 30th, your card will expire December 31st of the same year, if you purchase your card between July and December 31st, your card will expire June 30th of the following year.
Please Choose:
Visa______ Mastercard_____ Check_____ Money Order_____
Total Charged to Card:______________
Card #:_________________________________________ Exp. Date____________ 3digit code_____
Signature____________________________________________________________
Please Make Checks & Money Orders Payable To: "Mt. Olympus Inc."
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Mail to:
Fit and Natural Productions
4742 Shearwater Lane
Naples, Florida, 34119
HOTLINE 239.777.1576
