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3 month membership
Please complete this form to create your gym membership.
3 month membership
Price:
$160.00
(one time pay)
Member Name
*
First
Last
Date of Birth
*
Date Format: MM slash DD slash YYYY
Address
*
Street Address
Address Line 2
City
Alabama
Alaska
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District of Columbia
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Maine
Maryland
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Nevada
New Hampshire
New Jersey
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New York
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Ohio
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Rhode Island
South Carolina
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Tennessee
Texas
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Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming
Armed Forces Americas
Armed Forces Europe
Armed Forces Pacific
State
ZIP Code
Emergency Contact
Name
*
First
Last
Phone
*
Additional Family Members
Would you like to add additional family members?
I have no additional family members to add
Add one additional family member
Add two additional family members
Name
First
Last
Date of birth
Date Format: MM slash DD slash YYYY
Name
First
Last
Date of birth
Date Format: MM slash DD slash YYYY
Would you like to add tanning?
A fee of $75.00 ($25/month) will be added to your total today for tanning.
Yes! Please add tanning to my membership
No thanks
Would you like to add tanning?
A fee of $150.00 ($25/month per family member) will be added to your total today for tanning.
Yes! Please add tanning to our membership.
No thanks
Would you like to add tanning?
A fee of $225.00 ($25/month per family member) will be added to your total today for tanning.
Yes! Please add tanning to our membership.
No thanks
Membership Agreement
*
I accept this membership agreement
Membership Agreement
I understand that I am Signing a binding contract/note which will be processed & collected by Marine City Health & Fitness and/or its assigns or billing agents. My failure to attend regularly and utilize club facilities does not relieve me of my obligation to pay all agreed payments regardless of the circumstances. I understand that my membership is non-cancellable except as herein provided. Initial fees/down payments are non-refundable. Should \ default, ) agree to pay all costs of collection, including but not limited to Collection Agency fees, reasonable attorney fees, and all court costs, all of which may be paid or incurred by the holder of this note.
Renewal Terms:
The membership will autornatically renew at the membership rate at the time of renewal. Member may cancel membership within 30 days of renewal date without a fee with written notice of cancellation request.
A service charge will be applied for all returned checks, ACH debits (credit and debit card), and EFT transfers. I hereby submit to the sole and exclusive jurisdiction of the State of Michigan to the full extent permissible by law for the purposes of collection and/or any dispute arising from this contract. A $175.00 cancellation fee will apply if Marine City Health & Fitness agrees to nullify/void contract.
Waiver of Liability
*
I agree to this waiver of liability.
WAIVER OF LIABILITY FOR GYM USE
I/We hereby understand and acknowledge that the training, programs and events held by the Marine City Health and Fitness Gym may expose me to many inherent risks, including accidents, injury, illness or even death. I/We assume all risk of injuries associated with participation including, but not limited to, falls, contact with other participants, the effects of the weather, including high heat and/or humidity, and all other such risks being known and appreciated by me.
I/We hereby acknowledge my responsibility in communicating any physical and psychological concerns that might conflict with participation in activity. I/We acknowledge that I am physically fit and mentally capable of performing the physical activity I choose to participate in.
After having read this waiver and knowing these facts, and in consideration ol acceptance of my participation and the Marine City Health and Fitness Gym furnishing services to me, I agree, for myself and anyone entitled to act on my behalf, to HOLD HARMLESS, WAIVE AND RELEASE the Marine City Health and Fitness Gym, it officers, agents, employees, organizers, representatives, investors and successors from any responsibility, liabilities, demands, or claims of any kind arising out of my participation in the Marine City Health and Fitness Gym membership, training, programs and/or events.
By my signature I/We indicate that I/We have read and understand is Waiver of Liability. I am aware that this is a waiver and a release of liability and I voluntarily agree to its terms.
Security Agreement
*
I agree to this security agreement.
SECURITY AGREEMENT
Access into our facility is strictly by our key fob system. Our doors are monitored 24 hours a day, 7 days a week. DO NOT open the door for anyone! If you are caught letting someone in you will be assessed a $25 fine and possible loss of membership privileges. This is for the safety of ALL of our members as well as Marine City Health & Fitness ability to track memberships. By my signature I/We indicate I/We have read and understand this Security Agreement.
Code of Conduct
*
I agree to the code of conduct.
CODE OF CONDUCT
Marine City Health & Fitness strives to eliminate potential hazards from the facility and to comply with all applicable safety and health laws and standards. The possession, use, sale or transfer of illegal drugs or drug paraphernalia on gym property is prohibited. The possession or use of weapons/firearms, explosive devices or ammunition is prohibited, subject to local law. Any acts that could be perceived as violent, threatening, degrading or intimidating or could cause another individual to feel unsafe are also prohibited. Sexual or any other type of harassment is prohibited.
Each member is responsible for demonstrating integrity, listening with respect to others and to value differences. Members are responsible for cleaning up after themselves, including but not limited to machines and returning weights to the proper place. No offensive language is to be used or worn on clothing. All members must remain fully dressed at all times. To ensure the safety of all members you are responsible to individually fob in at all times. Those not complying with the process of using their own key fob will have their key fob deactivated and a $50.00 reinstatement fee will apply.
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