MEMBERSHIP  REGISTRATION FORM

Please print clearly:

Name(s) of Individual or Couple: _______________________________________________
(Note: If other members of your immediate family will be using Club Soda, please list here)

Address: _________________________________________________________________

City: _________________________________________________________________

Zip Code: _________________________________________________________________

Telephone: _________________________________________________________________

Email: _________________________________________________________________

Cell phone: _________________________________________________________________

 

 

MEMBERSHIP OPTIONS

Please choose one. Individual Memberships may be converted to family memberships at any time during the year.

¨ Prepaid Annual Membership, Individual, $500

¨ Prepaid Annual Membership, Family, $750

Make Check Payable to: Club Soda – Mattermatics, Inc.

Please Mail Payment to:

MATTERMATICS, INC.

6380 SPINNAKER LN.

ALPHARETTA, GA 30005