Membership Application

Membership Application

Choose Membership and Term Type

Is this Membership for you or you and your Spouse/Partner
Choose your Payment Term
Choose your Couple/Spouse Membership

Confirm Your Information

Applicant Information
Name
Name
First
Last
Address
Address
Address 1
Address 2
City
State
Zipcode

Spouse/Partner Information

Spouse First & Last Name
Spouse First & Last Name
First
Last

Primary Emergency Contact

Name
Name
First
Last

Secondary Emergency Contact

Name
Name
First
Last

Promo Code

If you have a promo code, please enter here. First Month Free offers will have a check for the cost of the first month included in your Membership packet.

Recruiter Information

If you were referred by a Second Call Defense Recruiter, please provide Name and/or ID#

Legal Disclaimer

THE APPLICANT WARRANTS THAT THE STATEMENTS AND RESPONSES TO THE QUESTIONS ON THIS APPLICATION ARE TRUE AND COMPLETE. THIS APPLICATION DOES NOT BIND THE COMPANY TO OFFER NOR APPLICANT ACCEPT MEMBERSHIP AGREEMENT, BUT IT IS AGREED THAT THIS APPLICATION SHALL BE THE BASIS OF THE MEMBERSHIP APPLIED FOR. ANY SUCH MEMBERSHIP AGREEMENT ISSUED BY THE COMPANY MAY BE CANCELLED BY THE COMPANY FROM INCEPTION UPON DISCOVERY THAT THE MEMBERSHIP WAS OBTAINED THROUGH ANY FRAUDULENT STATEMENT, OMISSION, OR CONCEALMENT OF ANY FACTS MATERIAL TO THE ACCEPTANCE BY THE COMPANY OF THE RISK OR HAZARD ASSUMED.
Do you agree to the terms?