Subscription Application Form


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YES! I'm EXCITED to start my membership at the low Charter Membership Rate because I am joining today!

I understand I can cancel at any time, online, with one click, simply by visiting the "manage your account" page. I also understand that even if the price for new members goes up, my $9.95 monthly rate will be guaranteed for life ("grandfathered") for as long as I remain a current member, and I can cancel at any time in the future, for any reason, with no obligation to continue.

Secure Subscription Form

We respect your privacy. The personal information requested below is for use in processing your credit card, which is done with secure encryption. We never reveal, share, or sell member information. For complete details see our Privacy Statement.

Customer Information

* = Required - Must match credit card billing address!

First Name [ required ]
Last Name [ required ]
Company
Address Line 1[ required ]
Address Line 2
City [ required ]
State [ US & Canada ]
State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Country [ required ]
Your E-mail Address [ required ]
Phone or Fax Number [ required ]

Shipping Information

Shipping same as billing address

Ship To First Name [ required ]
Ship To Last Name [ required ]
Ship to Company
Ship to Address Line 1[ required ]
Ship to Address Line 2
Ship to City [ required ]
Ship to State [ US & Canada ]
Ship to State/Province [ All other Countries ]
Zip/Postal Code [ required ]
Ship to Country [ required ]

Subscription Options

Choose Your Subscription Plan:	~~$9.95 Joining Fee~~ - Not in effect yet. Sign up now to lock in the current low charter membership rate... $9.95 per month automatic recurring billing - cancel anytime! $97 One time payment, non-recurring - 1 Year Paid in Full - (saves you $22 off of full price!)

Choose LOGIN Name [ required ]

Choose PASSWORD [ required ]at least six characters long, using alphas and numbers, no spaces.

Confirm PASSWORD [ required ]

Payment Information

Payment Method [ required ]

Prefer to pay via Paypal?

Credit Card Number [ required ]

Credit Card Security Code [ required on (MC/Visa/AMEX) ? ]

Expiration Date [ required ]

Name on Credit Card [ required ]

Is this a Renewal?

Do you wish to receive email alerts?

<<< Please Check The Box to acknowledge that you have read and understood our terms of use.

~~$9.95 Enrollment fee~~ and $9.95 monthly recurring - The enrollment fee is waived if you join now while charter rates are still available. Sign up now to save money and lock in your low charter membership rate

Please Note: Your card will show a charge from
"Burn The Fat Inner Circle."
Burn the fat inner circle is a division of Fitness Renaissance, LLC A New Jersey corporation


NOTE: It can take up to a minute to process the credit card information and obtain approval. Please do not press the submit button multiple times - doing so could cause double billing.
For the protection and privacy of our visitors and customers, as well as the security of the server, suspicious activities on our site are monitored, tracked and reported.

Please Note: Your card will show a charge from "Burn The Fat Inner Circle." Burn the fat inner circle is a division of Fitness Renaissance, LLC A New Jersey corporation

Please Note: Your card will show a charge from
"Burn The Fat Inner Circle."
Burn the fat inner circle is a division of Fitness Renaissance, LLC A New Jersey corporation