ScrubsTeamSix Home Base Membership Form First Name Last Name Your Email Address Which store do you frequent most? *note: rewards will still apply at all our stores! Fort Worth Hurst Lewisville Dallas Grapevine Payment Item Commander (1 year) – $19.95 Captain (1 year) – $29.95 Tax Amount: Select Payment Method Pay with Card (Stripe) Pay with Paypal I agree to the terms and conditions Submit Payment Please Wait… Contact Form Questions about your membership? Drop us a line! Name Email Address Confirm Address Phone Message Check to confirm you are not a robot Submit Please Wait…