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MEMBERSHIP AGREEMENT, LIABILITY WAIVER AND COVID EMERGENCY ACTION PLAN WAIVER

30WEST FITNESS & RECREATION, LLC

 

NOTE:  THIS DOCUMENT MUST BE READ AND SIGNED BEFORE THE PARTICIPANT IS PERMITTED TO USE THE FITNESS CENTER AT 30 WEST FITNESS AND RECREATION. THE PARTICIPANT AFFIRMS HAVING READ AND UNDERSTOOD IT AND IS IN AGREEMENT WITH ITS CONTENTS.

MEMBERSHIP AGREEMENT:

The undersigned ("Member"), desires to become a member of 30 West Fitness & Recreation, L.L.C. ("30 West”), and agrees to the following terms and conditions:

1.  PARQ: (To be filled out onsite) Member represents and warrants that all facts stated in the Physical Readiness Questionnaire (PARQ) submitted by Member are true and correct.  The PARQ is incorporated herein by reference and made a part of this Agreement.

2.  MEMBERSHIP ACCESS. Member will be issued both a member number and an access code, which will entitle Member to enter the premises and enjoy the use and benefit of the facilities of 30 West (collectively, the "Facility").  Member agrees not to allow any other person(s) access to the Facility using Member's access code, and Member will not allow anyone to enter the Facility along with Member.  Member agrees to safeguard the identity of the access code.  Management reserves the right to charge member responsible  for violation of conditions (i.e. member allows non-member to his/her access code to use gym will be charged the daily rate for each occasion allowing non-member to use access code and facility).  Should Member violate any conditions of Membership Access, the membership may be revoked with no refund, and criminal prosecution may be applicable.    

3.  FACILITY AND HOURS OF OPERATION. The Facility is an unmanned fitness center and, with the exception of any closures for maintenance or any mandatory shutdowns by property management or any governmental authority, is open daily 4am - midnight.

4.  DRESS POLICY. 30 West requires that members wear appropriate clothing and footwear while in the Facility. Appropriate clothing includes gym shorts, T-shirts, jogging suits, aerobic wear and sweat outfits. Street clothing and jeans are not considered appropriate clothing.  Members are required have a separate pair of clean shoes to wear when using fitness center.

5.  PERSONAL TRAINING.  Should Member wish to make arrangements for personal training with one of the other members who is a trainer or an outside trainer, such arrangement shall be solely and exclusively between Member and the trainer. 30 West is not a party to any arrangement between members of 30 West for personal training. 30 West shall not be liable in any way for results or lack of results obtained from any personal training arrangement activities between its members. All releases and waivers of liability herein apply to any and all fitness activities in which Member engages, regardless of any arrangement between members for personal training.  Any introduction(s) by 30 West of a member who is a personal trainer to Member shall not be considered by Member to be an endorsement of the trainer by 30 West.  No member of 30 West who is a personal trainer shall represent himself or herself to be an employee or an affiliate of 30 West in any way other than as a member of the Facility.  

6.  RULES AND REGULATIONS. Member acknowledges that 30 West operates under rules and regulations established for the safety and protection of its members, and agrees to be bound by such rules and regulations, as well by the rules and regulations subsequently approved and posted or otherwise published by 30 West. Such rules and regulations in effect from time to time are incorporated into this Agreement by reference. Facilities, equipment, hours, service, regulations and policies are subject to change from time to time, without prior notice, in the sole discretion of 30 West. Member agrees to accept such reasonable change(s) as a condition of membership. Member additionally recognizes:

  • Under no circumstances shall Member move exercise equipment or use the equipment in any manner not authorized by 30 West.
  • All equipment shall be wiped down by Member after each use, with the supplies provided by 30 West.
  • This membership is for Member, and Member only, and Member will not give access to another individual.
  • Member will not misuse the equipment.
  • All members must be at least eighteen (18) years of age, with the only exception being members sixteen (16) or seventeen (17) years old, whose membership and liability are in connection with and with permission of a legal guardian. Similarly, 30West allows membership to those fourteen (14) or fifteen (15) years old, who are under direct supervision at the facility by their parent or legal guardian 
  • Management reserves the right to grant special use permits.  
  • Members shall conduct themselves in a quiet, well-mannered fashion so as not to cause any disturbance which may interfere with the use and enjoyment of the Facility by any other member. Profanity or indecent language and/or behavior will not be tolerated. Any conduct deemed by 30 West, in its sole discretion, to be offensive, potentially harmful, dangerous or abusive will not be tolerated, and shall be grounds for termination of Member's membership by 30 West.
  • 30 West shall not be responsible for any lost or stolen items.
  • Member should not occupy any equipment for an extended period of time. Member should allow others waiting to use such equipment to work into their rotation.
  • The climate of the Facility is controlled by 30 West and is set to provide the optimum exercise environment for the majority of its members. Members shall not change or seek to change any environmental controls and shall never prop open any doors or windows to the Facility for any purpose.

7.  PROHIBITED ACTIVITIES.  Possession and/or use of alcohol, illegal drugs, and cigarettes (including e-cigarettes and all other forms of smoking) are prohibited within the Facility and grounds.  Member agrees not to use the Facility or engage in any activity at 30 West while under the influence of drugs, alcohol, or medication that may impair Member's ability to operate the equipment. No weapons of any kind are allowed. 30 West reserves the right, in its sole discretion, to limit the consumption of food or beverages, or to the use of outside equipment within the Facility. Gambling or gaming is prohibited within the Facility or on the premises.

8.  PAYMENT OF MEMBERSHIP FEES. All payments to 30 West are final and can be made by one of the following options:

  • Monthly EFT (Electronic Fund Transfer) via credit/debit card or bank account transfer
  • Paid in Full by Check or Cash

Should Member select the Monthly EFT Draft Payment option, Member agrees to pay the then-current monthly Membership Fee, plus applicable taxes, each month thereafter through automatic withdrawals from an account maintained by Member in a financial institution, pursuant to a debit authorization form signed by Member.  Additionally, Member shall pay with this Agreement, an initiation fee of Forty Dollars ($40.00).

9. CANCELLATION POLICY/TERM. All memberships of 30 West are either annual or monthly, and payments are due in advance. Automatic drafts will not be cancelled without thirty (30) days written notice, either by certified mail, hand-delivery to the management of  30 West, or by electronic means (i.e., email). No refunds will apply. Annual Contract member must pay the remaining amount of the annual contract if cancelling prior to the 12th month of membership.

We will provide you 30 days from your final payment so you don’t lose out on any time to use the fitness center.

The following are exemptions from the cancellation policy:

  • Written MD note indicating medical reason (i.e health concern or injury) it is advised to no longer engage in fitness activity at the fitness center.
  • Written proof of residential move at least 25 miles away from 30 West address.

 

10.  MEMBERSHIP FREEZE POLICY.  Members may choose to put a hold or “freeze” on the membership for up to 90 days ONCE per calendar year.If you pay via monthly EFT, we just stop the payments for 90 days. If you paid in full for your membership, your time is added to the membership when it expires. Membership will automatically renew after 90 days, unless formal cancellation by member is made.  

11. DEFAULT/REMEDIES.  Any monthly payment received more than ten (10) days after the due date shall be subject to a late charge of Twenty Dollars ($20.00), whichever is greater.  

12. BINDING EFFECT.  This Agreement shall be binding upon, inure to the benefit of, and be enforceable by the parties hereto and their respective successors and assigns.  

13. ENTIRE AGREEMENT. This Agreement, including the schedules, lists and other documents referred to in this Agreement which form a part of this Agreement, embody the entire agreement and understanding of the parties with respect to the subject matter contained in this Agreement. There are no restrictions, promises, warranties, covenants or undertakings, other than those set forth or referred to in this Agreement. This Agreement supersedes all prior agreements and understandings between the parties with respect to each subject matter.

14. GOVERNING LAW. This Agreement, and all documents mentioned herein by reference, shall be governed by the laws of the State of Minnesota.

15. FURTHER ASSURANCES. The parties agree to execute such further documents as may be necessary, proper or convenient, for the purpose of fully effectuating the terms and conditions of this Agreement.

16. SUSPENSION AND TERMINATION. I understand that 30 West may suspend or terminate my membership at any time, in it sole and absolute discretion, for non-payment of Membership Fees or for violation of any of 30 West’s policies and procedures, and that in so doing, 30 West assumes no further liability to adhere to the terms of this Agreement.

17. ACCEPTANCE OF TERMS. As a Member, I understand that I am entitled to use the Facility within the scope of the membership that I have selected, and that I am obligated to pay my dues and fees regardless of whether or not I use the Facility. I agree to promptly update 30 West of any change in my contact information (including address, telephone number or email address) or change in credit information.


I certify that I have read the foregoing Membership Agreement, and that by signing below, I acknowledge that I understand and agree to be bound by all of the terms and conditions hereof. I further acknowledge that a fully executed copy of this Membership Agreement has been provided to me. 

 

LIABILITY WAIVER

I HEREBY ASSUME ALL OF THE RISKS OF PARTICIPATING IN ANY AND ALL CLASSES, EVENTS AND ACTIVITIES HELD AT 30 WEST FITNESS AND RECREATION, IN USING ANY FITNESS EQUIPMENT LOCATED AT 30 WEST FITNESS AND RECREATION, OR THE FACILITY ITSELF, WHETHER INDEPENDENTLY AND/OR IN CONJUNCTION WITH ANY CLASS LEADER, FITNESS COACH, TRAINER, OR ANY OTHER PERSON, INCLUDING FELLOW PARTICIPANTS, MEMBERS OR GUESTS OF 30 WEST FITNESS AND RECREATION, including by way of example and not limitation, any risks that may arise from negligence or carelessness on the part of the persons or entities being released, from dangerous or defective equipment or property owned, maintained, or controlled by them, from negligent acts in teaching a class, leading an activity or event, or providing fitness instruction, coaching or training, or because of their possible liability without fault.

I certify that I am physically fit and that I am knowledgeable, have prepared, have trained and have the skill necessary for participation in this class, event or activity and for my use of equipment and/or the facility at 30 West Fitness and Recreation, and have not been advised to not participate by a qualified medical professional. I certify that there are no health-related reasons or problems that would preclude my participation in this class, event and/or activity at 30 West Fitness and Recreation, and/or my use of the equipment and/or facility at 30 West Fitness and Recreation.

I recognize that there are inherent risks in my participation in this class, event or activity at 30 West Fitness and Recreation, and my use of the equipment and/or facility at 30 West Fitness and Recreation may involve a test of a person's physical and mental limits and carries with it the potential for minor injuries, serious injuries, death or property loss.
The risks include, but are not limited to, those caused by terrain, facilities, temperature, weather, condition of participants, equipment, vehicular traffic, lack of hydration, and actions of other people including, but not limited to, participants, guests, volunteers, monitors, class leaders, teachers, fitness instructors, trainers or coaches, owners and/or producers or sponsors of the class, event, activity or owners, employees, and/or contractors who own and/or maintain the equipment and the facility. These risks are not only inherent to participants, but are also present for guests or volunteers.

As such, I affirm that I know, understand, appreciate and agree to assume sole responsibility for the inherent risks of my participation in classes, events and or activities at 30 West Fitness and Recreation, my use of the equipment and/or the facility at 30 West Fitness and Recreation.
I acknowledge that this Accident Waiver and Release of Liability Form will be used by the event, activity or facility owners, employees, independent contractors, teachers, class leaders, fitness coaches trainers, holders, sponsors, and organizers of any activity or class or equipment or facility use that I may participate, and that it will govern my actions and responsibilities at said activity, class, event, equipment, or facility use.
In consideration of my application and permitting me to participate in this class, event, activity, or use of equipment or the facility, I hereby take action for myself, my executors, administrators, heirs, next of kin, successors, and assigns as follows:

WAIVE, RELEASE, AND DISCHARGE 30 West Fitness and Recreation, LLC from any and all liability and claims, including but not limited to, liability and claims arising from the ordinary negligence or fault of the entities or persons released, for my death, disability, personal injury, property damage, property theft, or actions of any kind which may hereafter occur to me including my traveling to and from this activity, as well as THE FOLLOWING ENTITIES OR PERSONS: 30 West Fitness and Recreation, LLC and/or its directors, officers, members, mangers, employees, independent contractors, volunteers, representatives, and agents, ISI Ventures, LLC, and/or its directors, officers, members, managers, employees, independent contractors, volunteers, representatives, and agents, and the class, event or activity holders, sponsors, and volunteers, insurance carriers, suppliers, persons or entities maintaining the equipment and the facility; AND
INDEMNIFY, REIMBURSE, DEFEND, HOLD HARMLESS, AND PROMISE NOT TO SUE the entities or persons mentioned in this paragraph from any and all liabilities or claims made as a result of participation in this activity, whether caused by the ordinary negligence of the released parties or otherwise, including but not limited to, attorney’s fees, court costs and/or investigative costs.  This indemnification provision applies to all liability or claims made by the Participant, Participant’s parent or guardian, or others arising out of the injury or loss to Participant and claims of co-Participants, rescuers, and other arising from the conduct of the Participant during the participation in classes, events or activities or use of the equipment or facility.  I acknowledge that 30 West Fitness and Recreation, LLC, its directors, officers, members, managers, employees, independent contractors, volunteers, representatives, and agents are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific class activity or event on their behalf.

PARENT/GUARDIAN OF 14 AND 15 YEAR OLDS: I understand the equipment at 30 West may not be designed for children of any age; some children may have an increased risk of injury and that these injuries may have a permanent effect. I understand that any questions regarding my child’s risk for injury should be directed to my family physician. I acknowledge that I possess adequate family medical and hospitalization insurance coverage for the child. I understand that my child’s access to 30 West may vary and that local hours, rules, and restrictions apply. I agree that my child—age 14-15 years old—will be under my direct supervision whenever the child uses 30 West facilities.

The above release of liability extends to all phases of participation in classes, events, or activities and all areas of use of the equipment or facility, including but not limited to warm-ups, cleaning of equipment, full use of the facility, such as showers, locker rooms, changing rooms, beverage or food service areas, sidewalks, and parking lots.
I agree to follow all safety rules and instructions of 30 West Fitness and Recreation LLC, as well as its officers, members, managers, employees, independent contractors, class leaders, teachers, fitness instructors, coaches and trainers, volunteers, representatives, agents and representatives.  Furthermore, I hereby consent to receiving, at my sole cost, first aid, CPR, AED’s, medical treatment and transportation to a hospital by ambulance, as is deemed advisable in the event of my injury, accident, and/or illness during this class, event, activity, or use of equipment or the facility and I authorize the sharing of confidential or protected information to assist the first responders and medical professionals in caring for me.
Venue or jurisdiction for any claim or liability by a Participant shall be in St. Louis County, Minnesota and be governed by Minnesota law.  The undersigned Participant shall submit any
liability or claims covered by Accident Waiver and Release of Liability Agreement to binding arbitration.  

The Accident Waiver and Release of Liability Agreement shall be construed broadly to provide a release and waiver to the maximum extent permissible under applicable Minnesota law.  In the event that one portion of the Accident Waiver and Release of Liability Agreement is deemed to be void, this shall have no effect on the remaining portion of the Accident Waiver and Release of Liability, which shall still be fully enforced.

This Accident Waiver and Release of Liability Agreement shall remain valid until it is expressly revoked by written notice from me to 30 West or the termination of my membership whichever occurs first; provided, however, that any such revocation shall not in any manner affect my assumption of the risk, my waiver and release of liability and indemnification given hereunder for any acts or occurrences prior to the receipt of said written notice by 30 West or prior to termination of my membership.

I have read this Release of Liability and Waiver Agreement, and certify that I fully understand its terms, understand that I have assumed the risk of personal injury or property loss and have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement. 
Moreover, in so doing, I am freely and voluntarily participating in the class, event, or activity and/or am using the equipment or the facility with the full intent of releasing the provider of liability for injury or loss due to the inherent risks of the class, event, activity, and use of the equipment and facility as a result of the ordinary negligence of the provider.  

 

COVID-19 EMERGENCY ACTION PLAN WAIVER

30 West Fitness and Recreation, LLC is committed to providing a safe and healthy workplace for all our workers and members. To ensure we have a safe and healthy workplace, we have developed and revised the following COVID-19 Preparedness Plan in response to the COVID-19 pandemic. Managers and workers are all responsible for implementing this plan. Our goal is to mitigate the potential for transmission of COVID-19 in our workplaces and communities, and that requires full cooperation among our workers, management, and members. Only through this cooperative effort can we establish and maintain the safety and health of all persons in our workplaces.

Management and workers are responsible for implementing and complying with all aspects of this COVID-19 Preparedness Plan. 30 West Fitness and Recreation, LLC owners support enforcing the provisions of this policy and we encourage our workers to ask questions, raise safety and health concerns and offer suggestions related to the plan and its implementation.

Our members are our most important assets. We are serious about safety and health and keeping our workers working at 30 West Fitness and Recreation, LLC. Member involvement is essential in developing and implementing a successful COVID-19 Preparedness Plan. We have involved our members in this process by reaching out to various members for suggestions and expertise. Our COVID-19 Preparedness Plan follows State of Minnesota Industry Guidance for our business, Centers for Disease Control and Prevention (CDC) Guidelines, federal Occupational Safety and Health Administration (OSHA) standards related to safety and health precautions required in response to COVID-19 and applicable executive orders. The plan addresses the following:

  1. policies and procedures that assist in the identification of sick workers and ensure sick workers stay home;
  2. implementation of engineering and administrative controls for social distancing;
  3. worker hygiene and source controls;
  4. workplace building and ventilation protocols;
  5. workplace cleaning and disinfecting protocols;
  6. communications, training and supervision practices and protocols.
  7. additional protections and protocols for receiving and exchanging payment;

1. Policies and procedures that assist in the identification of sick workers and ensure sick workers stay home

Workers and members have been informed of and encouraged to self-monitor for signs and symptoms of COVID-19. The following policies and procedures are being implemented to assess workers’ and members’ health status prior to entering the workplace and to report when they are sick or experiencing symptoms.

All members and employees will review and sign an agreement in which they agree to stay home if they are sick or have any of the following symptoms:

  • Fever (>100.4) or Chills
    • ​If members or workers have not taken their temperature on the day of entry, a thermometer will be placed in the entryway and they should do so.
  • Sore throat
  • New or worsening cough, Runny nose or congestion
  • New or worsening shortness of breath
  • New or worsening muscle pain or fatigue
  • New or worsening loss of taste or smell
  • Nausea, diarrhea, or vomiting
  • New or worsening headaches 

Given the constraints of our facility occupant load restrictions set forth by the State of MN, it is recommended that “high risk” and vulnerable members self-identify and consider the risk/benefit of attending the gym. These individuals avoid peak use times when the gym is more likely to be at maximum occupant load capacity, such as between 6-9 a.m. and 2 - 7 p.m.

Based on what we know now, those at high-risk for severe illness from COVID-19 are:

  • People 65 years and older
  • People who live in a nursing home or long-term care facility

People of all ages with underlying medical conditions, particularly if not well controlled, including:

  • People with chronic lung disease or moderate to severe asthma
  • People who have serious heart conditions
  • People who are immunocompromised
    • Many conditions can cause a person to be immunocompromised, including cancer treatment, smoking, bone marrow or organ transplantation, immune deficiencies, poorly controlled HIV or AIDS, and prolonged use of corticosteroids and other immune weakening medications
  • People with severe obesity (body mass index [BMI] of 40 or higher)
  • People with diabetes or chronic kidney disease undergoing dialysis
  • People with liver disease

If any members or employees have developed symptoms or tested positive for Covid-19, they will immediately be placed on 10 day quarantine. Workers and members are expected to notify 30 West Fitness and Recreation, LLC ownership if they become symptomatic with COVID-19 like illness.

Within 24 hours of notification of exposure, a phone call will be made by the owners of 30 West Fitness and Recreation, LLC to each member who has accessed the facility within the timeframe of the individual testing positive to notify them of their exposure. These communications will specify exposure without compromising the privacy of workers’ or members’ health status and health information.

30 West Fitness and Recreation, LLC has implemented leave policies that promote workers staying at home when they are sick, when household members are sick, or when they are required to isolate or quarantine themselves or a member of their household. Accommodations for workers with underlying medical conditions or who have household members with underlying health conditions have been implemented.

2. Social distancing – maintaining of physical distancing

Social distancing will be implemented and maintained between workers and members in the facility through the following engineering and administrative protocols:

  • In any area of the facility where people are exercising or engaging in physical activity, the required social distancing is separation of at least 12 feet between all persons.
    • At all other times and locations in the facility, the required social distancing is six feet between all persons
    • Some equipment will be marked for non-use to allow for appropriate social distancing
  • 25% Occupant Capacity = 14 people
  • No in-person group classes, sessions, or activities are permitted until authorized by the State of MN
  • Violation of social distancing procedures may result in verbal warning, followed by written warning and potential revocation of membership privileges as deemed appropriate by ownership. 

3. Hygiene and source controls

Worker and member hygiene and source controls are being implemented at our workplaces at all times.

  • Required face coverings
    • Face coverings must be worn by all members and workers at all times. Individuals are not permitted to remove their face coverings during activities that involve a high level of exertion as was previously allowed
  • All workers and members will be required to sanitize hands upon entering the facility.
  • Workers are required to wear protective eyewear at the membership counter as social distancing is not practical in this situation.
  • Workers are required to wear gloves during all cleaning tasks.
  • Regular hand washing is encouraged and hand sanitizer is available throughout the building

4. Workplace building and ventilation protocols

Reopening the workplace includes necessary sanitation, assessment and maintenance of building systems including water, plumbing, electrical and HVAC systems. 30 West Fitness and Recreation, LLC has maintained all systems while closed with regular maintenance to ensure ready for opening. This includes overhead ducted heating and cooling system (HVAC) equipped with the Humiditrol® dehumidification system and touchscreen thermostat. In addition to the HVAC system, Heat Recovery Ventilation (HRV) air exchange system has been installed in order to provide additional air into the building while exhausting an equal amount of stale air to the outside. Our exchange rate is 30x per hour, twice what a hospital minimum requirement. All of our building and ventilation systems that are followed and documented.

5. Workplace cleaning and disinfection protocols

Regular housekeeping practices are being implemented, including routine sanitizing of the workplace and frequent sanitizing of high-touch areas. Workers have been instructed that personal equipment and tools should not be shared. Any shared equipment should cleaned before and after use by the user. Appropriate and effective cleaning and disinfectant supplies have been purchased and are available for use in accordance with product labels, safety data sheets and manufacturer specifications, and are being used with required personal protective equipment for the product.

6. Communications, training and supervision practices and protocols

This COVID-19 Preparedness Plan was communicated via face to face communication to all workers and members prior to resuming normal access to the facility and necessary training was provided. All members are required to sign agreement of understanding of 30 West Fitness and Recreation, LLC Covid-19 Preparedness plan. Owners are to monitor how effective the program has been implemented by daily review of surveillance. Owners and workers are to work through this new program together and update the training as necessary. This COVID-19 Preparedness Plan has been certified by 30 West Fitness and Recreation, LLC ownership and was posted throughout the workplace 12.18.2020. It will be updated as necessary.

7. Additional protections and protocols for receiving and exchanging payment

30 West Fitness and Recreation, LLC business model leads to little concerns regarding receiving payment, therefore additional protections related to exchange of payment will not be necessary.

 

Certified by:

Jen Gigliotti - Director of Member Services

Nick Gigliotti - Director of Operations

Candice Sjogren - Director of Marketing

Joel Sjogren -Director of Building Management & Recreation

Today's Date: January 22, 2021

I hereby WAIVE, RELEASE, AND DISCHARGE 30 West Fitness and Recreation, LLC, ISI Ventures, LLC, and its owners from any and all liability and claims. I hereby INDEMNIFY, REIMBURSE, DEFEND, HOLD HARMLESS, AND PROMISE NOT TO SUE 30 West Fitness and Recreation, LLC, ISI Ventures, LLC, and its owners. I hereby acknowledge that 30 West Fitness and Recreation, LLC, ISI Ventures, LLC, and its owners are NOT responsible for the errors, omissions, acts, or failures to act of any party or entity conducting a specific class activity or event on their behalf.

I agree to follow all safety rules and instructions of 30 West Fitness and Recreation LLC, Covid-19 Preparedness Plan. As such, I affirm that I know, understand, appreciate and agree to assume sole responsibility for the inherent risks of my use of the equipment and/or the facility including your interactions with others while at 30 West Fitness and Recreation.

I have read this 30 West Fitness and Recreation LLC, Covid-19 Preparedness Plan, and certify that I fully understand its terms, understand that I have assumed the risk of personal injury or property loss and have given up substantial rights by signing it, and sign it freely and voluntarily without any inducement.

Moreover, in so doing, I am freely and voluntarily participating in the class, event, or activity and/or am using the equipment or the facility with the full intent of releasing the provider of liability for injury or loss due to the inherent risks of the class, event, activity, and use of the equipment and facility as a result of the ordinary negligence of the provider.

First Gym Member's Name

First Name*

Last Name*

Phone*
First Gym Member's Date of Birth*
First Gym Member's Signature*
Second Gym Member's Name

First Name*

Last Name*
Second Gym Member's Date of Birth*
Third Gym Member's Name

First Name*

Last Name*
Third Gym Member's Date of Birth*
Fourth Gym Member's Name

First Name*

Last Name*
Fourth Gym Member's Date of Birth*
Fifth Gym Member's Name

First Name*

Last Name*
Fifth Gym Member's Date of Birth*
Sixth Gym Member's Name

First Name*

Last Name*
Sixth Gym Member's Date of Birth*
Seventh Gym Member's Name

First Name*

Last Name*
Seventh Gym Member's Date of Birth*
Eighth Gym Member's Name

First Name*

Last Name*
Eighth Gym Member's Date of Birth*
Ninth Gym Member's Name

First Name*

Last Name*
Ninth Gym Member's Date of Birth*
Tenth Gym Member's Name

First Name*

Last Name*
Tenth Gym Member's Date of Birth*
Parent or Guardian's Email Address

Email*

Confirm Email*
Check to receive information, news, and discounts by e-mail.
Parent(s) or court-appointed legal guardian(s) must sign for any participating minor (those under 18 years of age) and agree that they and the minor are subject to all the terms of this document, as set forth above.
Parent or Guardian's Name

First Name*

Last Name*

Phone*
Parent or Guardian's Date of Birth*
Parent or Guardian's Signature*
Electronic Signature Consent*
By checking here, you are consenting to the use of your electronic signature in lieu of an original signature on paper. You have the right to request that you sign a paper copy instead. By checking here, you are waiving that right. After consent, you may, upon written request to us, obtain a paper copy of an electronic record. No fee will be charged for such copy and no special hardware or software is required to view it. Your agreement to use an electronic signature with us for any documents will continue until such time as you notify us in writing that you no longer wish to use an electronic signature. There is no penalty for withdrawing your consent. You should always make sure that we have a current email address in order to contact you regarding any changes, if necessary.


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