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  1. ═══════════════════════════════════════════════════════════════════════════════                                                                                                     TRI COUNTY NAUTILUS FITNESS CENTER                                                  Membership Renewal Record                                                                                                          ═══════════════════════════╦═══════════════════════════╦═══════════════════════      Effective Dates      ║  From:                    ║  To:                  ═══════════════════════════╩═════════════════╤═════════╩═══════════════════════  Name:                                      │ Phone:                          ─────────────────────────────────────────────┴─────────────────────────────────  Address:                                                                     ─────────────────────────────────────────────┬───────────────┬─────────────────  City:                                      │ State:        │  ZIP:           ─────────────────────────────┬───────────────┼───────────────┴─────────────────  Membership Type:           │Fee:$          │ ■ Paid  ■ Payments $      /Mo.  ─────────────────────────────┴───────────────┴─────┬───────────────────────────  Received By:                                     │ Date:                     ───────────────────────────────────────────────────┴───────────────────────────                                                                                                                                                                                                                                                                                                                            ═══════════════════════════════════════════════════════════════════════════════                                                                                                     TRI COUNTY NAUTILUS FITNESS CENTER                                                  Membership Renewal Record                                                                                                          ═══════════════════════════╦═══════════════════════════╦═══════════════════════      Effective Dates      ║  From:                    ║  To:                  ═══════════════════════════╩═════════════════╤═════════╩═══════════════════════  Name:                                      │ Phone:                          ─────────────────────────────────────────────┴─────────────────────────────────  Address:                                                                     ─────────────────────────────────────────────┬───────────────┬─────────────────  City:                                      │ State:        │ ZIP:            ─────────────────────────────┬───────────────┼───────────────┴─────────────────  Membership Type:           │Fee:$          │ ■ Paid  ■ Payment $       /MO.  ─────────────────────────────┴───────────────┴─────────────────────────────────                                                                                                                                                                                                                                                                                                                            ═══════════════════════════════════════════════════════════════════════════════                                                                                                     TRI COUNTY NAUTILUS FITNESS CENTER                                                  Membership Renewal Record                                                                                                          ═══════════════════════════╦═══════════════════════════╦═══════════════════════      Effective Dates      ║  From:                    ║  To:                  ═══════════════════════════╩═════════════════╤═════════╩═══════════════════════  Name:                                      │ Phone:                          ─────────────────────────────────────────────┴─────────────────────────────────  Address:                                                                     ─────────────────────────────────────────────┬───────────────┬─────────────────  City:                                      │ State:        │ ZIP:            ─────────────────────────────┬───────────────┼───────────────┴─────────────────  Membership Type:           │Fee:$          │ ■ Paid  ■ Payment $       /Mo.  ─────────────────────────────┴───────────────┴─────────────────────────────────