• MEMBERSHIP APPLICATION

    MEMBERSHIP APPLICATION

  • Please select an appropriate membership category and complete the membership application below.

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    • PRIMARY ADULT: (Responsible for account and any changes) 
    • SECONDARY ADULT 
    • CHILDREN: (Dependents under 22 years of age; At age 22, Dependents wishing to remain members will need own account) 
    • ADDRESS 
    • Billing 
    • All dues and fees are subject sales tax. In the event that Member's account remains unpaid for 60 days after the billing date, the Club shall have the right at any time dues thereafter to charge the account provided therefore, without any further authorization or signature of Member. Member understands that it is Member's responsibility to avalidauthorizedaccount or credit card on file with the Club at all times and to inform the Club of a change in the particular credit card to be charged. Upon termination keep of expulsion ormembership,Member authorizes the Club to charge the account or credit card provided for the outstanding balance on Member's account, without any furtherorsignature of Member. Member understands that they can never be assessed as a matter of contract with the City Club and that it is further understood authorization and agreed that Member assumes no liabilities in connection with membership other than sums set out above and charges incurred through use of the Club. Member agrees conformtoandbe toboundby rules and regulations of City Club as published on the Club website www.cityclubatriverranch.com. Member understands that these are subjecttochange and that violation of regulations may result in termination of Club privileges. I understand that any exercise program I undertake may create physical and stresssubsequent harmful effects. I agree that it is solely my responsibility and not the responsibility of the Club to request me to consult with a physician prior to commencing any exercise program, to remain under medical supervision is that is indicated, and to seek medical assistance in the event of an injury. I recognize that the oftheentails some risk of accidental injury to myself and to others and agree that I will use such equipment and facilities with due care. City Club at River useequipment Ranchand its owners,employees, and agents assume no liability for persons who undertake physical activity. Every Member, family member, and guest using the Club's facilitiesdoessoathisorher own risk, and the Club is not responsible for any injuries occurring to such persons. All Members, family members, and their guests expressly hold harmless, waive, and release the Club from any and all claims relating to or arising out of their use of the Club's facilities. Membership is non-transferable. Initiation Fee is non-refundable. Upgrades in Membership type will result in additional Initiation Fee. Resignation is required in writing by the 29th and takes effect on the next billing cycle.

    • PHOTOGRAPHY/MEDIA/AUDIO RELEASE 
    • APPROVAL 
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  • AUTOMATIC PAYMENT PROGRAM/ ONE TIME CHARGE TO CREDIT CARD

    City Club at River Ranch is pleased to offer members two options for the automatic payment of membership accounts. Payments will be posted on the first of every calendar month, and statements can be viewed online throughout the month to ensure accuracy of transactions on each account. Please fill out the appropriate information below and email form to membership@cityclubrr.com, or mail form to City Club at River Ranch 1100 Camellia Boulevard, Ste. 202 Lafayette, Louisiana 70508.

    • Option I: Automatic Bank Draft (Recurring) Attach a voided copy of a check from your checking account (deposit slips do not sufficient. Authorization Agreement for Preauthorized Payments (ACH Debits)I(we) hereby authorize City Club at River Ranch, hereinafter called COMPANY to initiate debit entries to my (our) Checking account indicated below, and the depository named below, hereinafter called DEPOSITORY, to debit such account. 
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    • This authority is to remain in full force and effect until COMPANY has received written notification from me/us of its terminationinsuchtime and in such manner as to afford COMPANY and DEPOSITORY a reasonable opportunity to act upon it.

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    • Option II: Automatic Credit Card Draft (Recurring) * Must include a copy of a valid a government issued I.D. 
    • I authorize City Club at River Ranch to bill account charges to the credit card on file the first of each month. I acknowledge that all credit card transactions will incur an additional 3% service fee.

      PLEASE CALL OUR MEMBERSHIP TEAM WITH YOUR CREDIT CARD DETAILS. 

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  • Physical Activity Readiness Questionnaire (PAR-Q)

  • Regular physical activity is fun and healthy, and increasingly more people are starting to become more active everyday. Being more active is very safe for most people. However, some people should check with their doctor before they start becoming more physically active.
    If you are planning to become more physically active than you are now, start by answering the seven questions in the box below. If you are between the ages of 13, the PAR-Q will help you decide if you should check with your doctor before you start. Even if you answer NO to all of the PAR-Q questions below, however, it may still be a good idea for you to check with your doctor before you start. And if you are over 69 years of age, and you are not used to being very active, you should check with your doctor.

    • Common sense is your best guide when you answer these questions. Please read the questions carefully and answer each one honestly. 
    • If you answered YES to one or more questions: 
    • Talk to your doctor by phone or in person BEFORE you start becoming more physically active or BEFORE you have a fitness appraisal. Tell your doctor about the PAR-Q and which questions you answered YES.


      • You may be able to do any activity your want – as long as you start slowly and build up gradually. Or, you may need to restrict your activities to those that are safe for you. Talk with your doctor about the kinds of activities you wish to participate in and follow his/her advice.

      • Find out which programs are safe and helpful for you.
    • If you answered NO to one or more questions: 
    • If you answered NO honestly to all PAR-Q questions, you may decide that you are ready to:


      • Start becoming more physically active – begin slowly and build up gradually. This is the safest and easiest way to go.

      • Take part in a fitness appraisal – this is an excellent way to determine your basic fitness so that you can plan the best way for you to live actively.
        But even if you answered NO to all of the questions, it may still be a good idea for you to check with your doctor before becoming more physically active.
    • Delay becoming more active: 
      • If you are not feeling well because of a temporary illness such as a cold or a fever-wait until you feel better, or
      • If you are or may be pregnant – talk to your doctor before you start becoming more active.


      Please Note: If your health changes so that you then answer YES to any of the above questions, tell your fitness or health professional. Ask whether you should change your physical activity plan.

    • Informed use of the PAR-Q:  
    • The City Club at River Ranch and its owners, employees, and agents assume no liability for persons who undertake physical activity, and if in doubt after completing this questionnaire, consult your doctor prior to physical activity. I understand that any exercise program I undertake may create physical stress and subsequent harmful effects. I agree that it is solely my responsibility and not the responsibility of the Club to request me to consult with a physician prior to commencing any exercise program, to remain under medical supervision is that is indicated, and to seek medical assistance in the event of an injury. I recognize that the use of the equipment entails some risk of accidental injury to myself and to others and agree that I will use such equipment and facilities with due care. Every Member, family member, and guest using the Club's facilities does so at his or her own risk, and the Club is not responsible for any injuries occurring to such persons. All Members, family members, and their guests expressly hold harmless, waive, and release the Club from any and all claims relating to or arising out of their use of the Club's facilities.

    • I have read, understood and completed this questionnaire. Any questions I had were answered to my full satisfaction. 
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    • SUBMIT APPLICATION 
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