Membership Agreement

Please Print This Form and Complete It.

Name __________________________________________________

Address ________________________________________________
Phone __________________________________________________


Compliance with Rules. I agree to abide by all Fitness Center membership rules which may be posted at the facility or issued orally and which may be amended from time to time in the sole discretion of Bethel University. I agree that improper unauthorized use of the facility may result in member suspension or cancellation. Fitness Center may suspend or cancel the rights, privileges and membership of any member whose actions are detrimental to the use and enjoyment of the facilities.
Initial your acceptance to abide by the Fitness Center rules here ___________________

Cancellation Rights. You may cancel this contract one of the following reasons by delivering written notice of cancellation to the Fitness Center:
(a) If you move your residence or your place of employment more than twenty-five (25) miles from the Fitness Center;
(b) Upon a doctor's order, you cannot physically or medically receive the services because of significant physical or medical disability for a period in excess of one 1 month.
Payment Authorization. By signing this Agreement, you are authorizing Bethel University Wildcat Health & Fitness Complex ("Fitness Center") to electronically bill your bank account or credit card for your monthly dues (EFT, preauthorized check or credit card charge) on a monthly basis for a period of (6) six months, and for your convenience the automatic billing will automatically renew every month after the initial 6 months period at the same rate unless you tell our staff to cancel the contract at the end of the six month contract period. If your monthly dues are delinquent for two (2) consecutive months, the remainder of any balance will be payable in full to avoid interruption of services unless you meet the requirements for cancellation above for the
monthly amount of $_______.
Initial your acceptance of the one year membership monthly rate here _________________

Name as it appears on credit card or bank draft:____________________________________
Credit Card # or Bank Draft information:__________________________________________
Credit Card Expiration date: _____________________________________

No Supervision. You are purchasing a membership at a facility that allows you access at any time. As such, you are aware that there will be no supervision or assistance. You are also aware that if you are injured, become unconscious, suffer a stroke or heart attack that there will likely be no one to respond to your emergency and that this facility has no duty to provide assistance to you. Even though the Fitness Center is equipped with emergency panic buttons and surveillance cameras it is likely that should you require immediate assistance none will be provided.

Acknowledgment of Risk and Waiver of Liability. I voluntarily assume the risk of injury, accident, death, loss, cost or damage to my person or property which might arise from my use of the Fitness Center and I agree to hold harmless and release the Fitness Center, employees, officers, and agents from any and all liability. I certify that I am in good physical health and I am able to undertake and engage in the range of physical activities in which I choose to participate. I assume all responsibility for updating the facility with respect to any changes in my physical or mental condition and for reporting all injuries sustained at the facility to the Fitness Center staff. This waiver, release and indemnification agreement includes, without limitation, all injuries which may occur as a result of (a) my use of all amenities and equipment in the facility and my participation in any activity or personal training, (b) sudden unforeseen malfunctioning of any equipment and (c) my slipping or falling while in the facility or on the facility premises, including adjacent sidewalks and parking areas. I acknowledge that I have carefully read this waiver, release and indemnification agreement and fully understand that it is a release of liability.
Initial your acceptance of your No Supervision and your Acknowledgment of Risk and Waiver of Liability here ________

General. This contract represents the complete understanding between you and the Fitness Center. No representations, written or oral, other than those contained in this contract are authorized or binding upon the Fitness Center. You understand that you are obligated to pay your membership fee regardless of whether you use the facility. You agree to promptly update the Fitness Center of any changes of address, phone and/or bank account/credit card information. At the end of the term of this membership contract, it shall continue in effect on a month to month basis unless new rates have been installed or you provide notice of cancellation to terminate this contract.

I certify that I have read and understand all of the terms of this agreement and agree to abide by all of the terms of this agreement.
Signature: _____________________________________________________
Date: ______________________________