Join Us Membership Form

Facility Name*
Please provide at least 1 facility information you operate.
Facility Address*
Street Address City State ZIP Code
Facility Website
Facility type*
- RCFE
- ARF
Facility County*
Facility/Primary Contact*
First Last
Primary Contact Email Address*
Primary Contact Mobile Phone Number*
Alternate Phone Number
Licensee Name*
Primary Operator/Owner*
Mailing Address*
Street Address Address Line 2 City State ZIP Code
How many RCFE facilities do you operate?*
Please enter a number from 0 to 25.
How many ARF facilities do you operate?*
Please enter a number from 0 to 25.
Choose Membership*
- $600 - Annual Membership Payment
- $300 - Semi-Annually Payment
- $150 - Quarterly Payment
Total
$0.00
This field is hidden when viewing the form
Free Trial
- I'd like to sign up for the 60 day FREE trial
Credit Card
Card Details
Cardholder Name
The credit card field will initiate once the payment condition is met.
Membership Terms
I agree to the following terms: 1) 6Beds membership dues is $600 annually, $300 semi-annually and $150 quarterly. 2) Membership fees are payable by credit card and the member’s chosen payment frequency of annually, semi-annually or quarterly 3) I understand that I can cancel the membership on or after the anniversary date; 4) Membership cannot be cancelled prior to the anniversary date. I acknowledge that the origination of automatic electronic payment to my account must comply with the provisions of U.S. law. 5) I certify that I am an authorized user of this credit card account and will not dispute the scheduled transactions with my credit card company; so long as the transactions correspond to the terms indicated in this authorization form.

6BEDS is a Mutual Benefit NON-PROFIT Corporation. Part of the membership dues is tax-deductible (consult with your tax advisor). Membership dues are non-refundable.
Signature*

Membership Terms