Fitness at SPS Tower Membership Application

Fitness at SPS Tower Membership Form

333 South Seventh Street, Minneapolis, MN 55402

Name *

Last Name First Name Middle Initial

Home Address *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code

Employer *

Employer Suite Number or Floor *

Work Email Address *

example@example.com

Work Phone Number

Birth Date *

Date

Emergency Contact *

Emergency Contact Phone *

Your personal information and email will not be used for any outside solicitation or marketing purposes.

Please read, initial and sign.

I acknowledge that membership cards are non-transferable and must be shown at all times for admittance to the Fitness at SPS Tower facility.

initial *

Please provide the first five digits (six digits when applicable) of your access card. *

By signing, I acknowledge that I have read and understand the words and language in the Membership Policies listed below.

Signature *

Clear

Date *

Date

Fitness at SPS Tower Membership Benefits and Policies

1. Membership Benefits. For current program information, call Fitness at SPS Tower at 612-673-6747 or inquire at the front desk.

2. Membership Eligibility: Exclusive membership to Fitness at SPS Tower is free to all clients in the building. Proper proof of affiliation to SPS Tower, such as employee identification or an employer's written acknowledgement of employment, will be required at time of registration.

3. Access: Members must use a valid building access card to enter Fitness at SPS Tower. Fitness at SPS Tower reserves the right to reduce hours for maintenance purposes, severe weather or any other reason beyond control of SPS Tower. Access cards must be scanned upon entry every time the member comes to the fitness center, no exceptions.

4. Change in Contact Information: Member must notify Fitness at SPS Tower staff in writing when any contact information changes, including access card number. Primary correspondence will be done via email.

5. Cancellations: If you move out of the building, you will no longer have access to Fitness at SPS Tower. Please send us an email or stop by the front desk to let us know so we can take you off of our mailing list and cancel your membership.

6. Membership Cards, Access & Replacement Fees: These membership cards are non-transferable and must be shown at all times for admittance to Fitness at SPS Tower. Transference, duplication, or alteration of membership cards will result in termination of membership. Please scan your membership card each time you check in so we can keep our reporting numbers accurate. Replacement fees may be charged for lost cards.

7. Facility Closures: All facilities, programs, and services are subject to availability. Fitness at SPS Tower Facility will be closed on national holidays. In addition, maintenance closures may occur throughout the year to ensure the safety, cleanliness and quality of our facility. Fitness at SPS Tower's hours are Monday through Thursday 6:00 a.m. to 7:00 p.m. and Friday 6:00 a.m.to 6:00 p.m. Hours are subject to change.

8.Emergencies: In the event of an emergency within the Fitness Center, notify a staff member immediately and follow the staff member's instructions. If you have any injury or adverse reaction to exercise, please alert the staff so they may contact emergency services to assist

9.Member Safety: If a member is involved in a medical incident or if the fitness staff determine a member is at an increased risk for injury from physical activity for any reason, that member may be asked to provide a completed medical clearance form to Fitness at SPS Tower staff. Any personal health information collected by staff will be treated as confidential to the extent the law allows. Please report any incidents or injuries immediately to Fitness at SPS Tower staff member. If a staff member is not available, there is a phone in the office and an emergency pull cord located at the front desk. AdvantageHealth Corporation and SPS Tower suggest exercising only when at least one other person is present in the fitness center.

10. Equipment Usage: Share equipment and allow others to use strength equipment when doing multiple sets. Do not drop weights or machine plates. Re-rack all weights/equipment to their designated storage areas. Benches must be kept out of walkways. Members must wipe equipment with the cleaning materials provided. Please report any equipment failures to the staff on duty.

11. Locker Policies: Fitness at SPS Tower is not responsible for personal belongings and is not liable for items that may be lost, stolen or cleared. Use the pull-out key to lock your locker during your workout time only. Lockers are not for overnight use, full day storage or for personal use outside of fitness center. Lost locker keys may be assessed a fee.

12. Dress Code: Appropriate workout attire must be worn at all times, including shirt, closed-toe shoes and shorts/pants. No profane or inappropriate clothing will be allowed. The Fitness Staff reserves the right to ask any member to change clothes.

13. Member Conduct: No food or drinks (except fitness nutrition such as bars, gels and fluids in closed containers) are allowed. Cell phone use is only allowed for music. Please refrain from having conversations on your cell phone when in the fitness center. No personal items (i.e. gym bags) may be left in exercise areas or held by staff. No smoking, drugs, or alcohol are permitted, and members may not use equipment while under the influence. Harassment of any sort - verbal, physical or visual - will not be tolerated.

14. Group Exercise Policies: Classes may be canceled or altered without notice. Report any incidents or injuries immediately to the Fitness

15. Change in Management: AdvantageHealth Corporation has been contracted by SPS Tower to operate the Fitness Center. AdvantageHealth Corporation expressly reserves the right, for any reason and at any time, to assign this agreement to SPS Tower or to a subsequent third party operator of the Fitness Center. Notice of any such assignment may be provided.

16. Code of Conduct: Fitness at SPS Tower members agree to abide by the Fitness at SPS Tower's Code of Conduct. For the full text of the Code of Conduct, please talk to a Fitness at SPS Tower staff member.

Fitness at SPS Tower is managed by AdvantageHealth Corporation

I have read and acknowledged the benefits and policies listed above. *

Yes

If you answer "Yes" to any one or more of the questions below, AdvantageHealth Corporation, Transwestern and Fitness at SPS Tower highly recommend you see your physician before beginning an exercise program. Your consent to the Waiver of Liability and the Membership Form acknowledges your understanding of the Personal Health History and recommendations. You can obtain a Physician Referral Form from a Fitness at SPS Tower staff person that can be reviewed and completed by your health care provider.

1. Are you over 40 AND unaccustomed to vigourous activity?

Yes

No

2. Have you ever had a heart attack?

Yes

No

3. Have you ever been told by a doctor that you have high blood pressure, a heart murmur, heart or lung disease?

Yes

No

4. Is your heartbeat ever irregular or do you have spells where it suddenly goes fast?

Yes

No

5. Do you have chest, neck, shoulder or arm pain or pressure during or after exercise?

Yes

No

6. Are you taking medications for your heart?

Yes

No

7. Do you get out of breath with moderate exertion?

Yes

No

8. Do you have bone or joint problems?

Yes

No

9. Is your cholesterol high?

Yes

No

Fitness at SPS Tower is managed by AdvantageHealth Corporation

AdvantageHealth Corporation

Fitness at SPS Tower Waiver

333 South Seventh Street, Minneapolis, MN 55402

Waiver of Liability, Assumption of Risk, and Indemnity Agreement

Waiver: In consideration of permission to use, today and on all future dates, the property, facilities, staff, equipment, services, and programs of Fitness at SPS Tower, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue AdvantageHealth Corporation, Transwestern, and the ownership of SPS Tower, as well as any successors, assigns, affiliates and subsidiaries, and any of their directors, officers, employees, managers, members, and agents from liability from any and all claims including the negligence of Fitness at SPS Tower's facilities and programs resulting in personal injury, accidents or illnesses (including death), and property loss arising from, but not limited to, participation in activities, classes, observation, and use of facilities, premises, or equipment. I further release, waive, discharge and covenant not to sue Transwestern, the ownership of Fitness at SPS Tower, and their successors, assigns, affiliates, subsidiaries, or any of their directors, officers, employees, managers, members or agents in connection with the provision any health and fitness related services and programs provided by AdvantageHealth Corporation and its employees at Fitness at SPS Tower.

Signature of User *

Clear

Date *

Date

Print Name *

Assumption of Risks: Physical activity, by its very nature, carries with it certain inherent risks that cannot be eliminated regardless of the care taken to avoid injuries. Fitness at SPS Tower has facilities for and provides for activities such as weight lifting, running, aerobic activities, classes and sporting activities. Some of these involve strenuous exertions of strength using various muscle groups, some involve quick movements involving speed and change of direction, and others involve sustained physical activity which places stress on the cardiovascular system. The specific risks vary from one activity to another, but the risks range from 1) minor injuries such as scratches, bruises, and sprains 2) major injuries such as eye injury or loss of sight, joint or back injuries, heart attacks, and concussions 3) catastrophic injuries including paralysis and death.

I have read the previous paragraphs and I know, understand, and appreciate these and other risks that are inherent in the activities made possible by Fitness at SPS Tower's Facilities and Programs. I hereby assert that my participation is voluntary and that I knowingly assume all such risks.

Indemnification and Hold Harmless: I also agree to INDEMNIFY AND HOLD AdvantageHealth Corporation, Transwestern, and the ownership of SPS Tower, as well as their respective successors, assigns, affiliates, subsidiaries, and any of their directors, officers, employees, managers, members, and agents HARMLESS from any and all claims, actions, suits, procedures, costs, expenses, damages and liabilities, including attorney's fees brought as a result of my involvement at Fitness at SPS Tower to reimburse them for any such expenses incurred.

Severability: The undersigned further expressly agrees that the foregoing waiver and assumption of risks agreement is intended to be as broad and inclusive as is permitted by the law of the State of Minnesota and that if any portion thereof is held invalid, it is agreed that the balance shall, notwithstanding, continue in full legal force and effect to the maximum extent permissible.

Acknowledgement of Understanding: I have read this waiver of liability, assumption of risk, and indemnity agreement, fully understand its terms, and understand that I am giving up substantial rights, including my right to sue. I acknowledge that I am signing the agreement freely and voluntarily and intend by my signature to be a complete and unconditional release of all liability to the greatest extent allowed by law.

Signature of User *

Clear

Date *

Date

Print Name *

Fitness at SPS Tower is managed by AdvantageHealth Corporation