New Member Application – Red Phone Booth

Location - Select Your Home Lounge *

Primary Applicant Name *

First

Last

Please enter your legal name (must match photo identification)

Occupation

Email *

Phone *

Address *

Address Line 1

Address Line 2

City

State

Zip Code

Membership Type

Membership Level - Select One *

Cigar Locker Name Plate (Up to 18 Characters)

Please Enter Text (Cigar Locker Name Plate)

Please enter the exact text you would like on your locker's name plate.

Additional Members (Corporate)

Name

First

Last

Email

Confirm Email

Phone

Additional Member #2

Name

First

Last

Email

Confirm Email

Phone

Additional Member #3

Name

First

Last

Email

Phone

Additional Member #4

Name

First

Last

Email

Confirm Email

Phone

Applicant Signature

Signature *

I understand to guarantee my membership stays continuous with no interruptions or changes of benefits, I understand and agree to adhere to all Red Phone Booth rules and regulations as amended from time to time. Red Phone Booth reserves the right to suspend or cancel membership privileges at any time or for any reason. I certify that the credit card listed is issued to me and agree to always keep a valid and approved credit card on file with Red Phone Booth. All memberships will automatically renew, and my card will be charged on an annual basis. I may cancel my membership at any time without refund with a 30-day written notice.

Please Confirm Today's Date *