[Previous code remains exactly the same until the Start Your Membership Now button section]
Start Your Membership
First Name
Last Name
Email Address
Phone Number
Membership Type
Basic Membership ($99/month)
Premium Membership ($199/month)
Elite Membership ($299/month)
Preferred Training Time
Morning (6AM - 12PM)
Afternoon (12PM - 5PM)
Evening (5PM - 10PM)
Additional Notes
I agree to the terms and conditions
Submit Application