PIVOT FITNESS

80 SOUTH 8TH STREET, SUITE 340, MINNEAPOLIS MN 55402

WWW.PIVOTFITNESS-IDS.COM

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 Pivot Fitness Center facility.

Please provide the FULL access number on the back of your access card (required for access

By signing, I acknowledge that I have read and understand the words and language on this page and in the Waiver of Liability, Assumption of Risk, and Indemnity Agreement on the reverse side of this form.

Personal Health History

If you can answer "Yes" to any one or more of the below questions, AdvantageHealth Corporation, Accesso Partners LLC., Accesso Services LLC. and the Pivot Fitness Center 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. 

1. Are you over age 40 AND unaccustomed to vigorous activity?

2. Have you ever had a heart attack?

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

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

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

6. Are you taking medications for your heart?

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

8. Do you have bone or joint problems?

9. Is your cholesterol high?

PIVOT FITNESS at IDS is managed by AdvantageHealth Corporation.

PIVOT FITNESS - IDS CENTER MEMBERSHIP FORM

80 SOUTH 8TH STREET, SUITE 340, MINNEAPOLIS MN 55402

WWW.PIVOTFITNESS-IDS.COM

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 the Pivot Fitness Center, I, for myself, my heirs, personal representatives or assigns, do hereby release, waive, discharge, and covenant not to sue AdvantageHealth Corporation, Accesso Partners LLC, Accesso Services LLC, BRI 1855 IDS Center LLC, 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 Pivot Fitness Center'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 AdvantageHealth Corporation, Accesso Partners LLC, Accesso Services LLC, BRI 1855 IDS Center LLC, and their successors, assigns, affiliates, subsidiaries, or any of their directors, officers, employees, managers, members or agents in connection with the provision of any health and fitness related services and programs provided by AdvantageHealth Corporation and its employees and/or contractors at the Pivot Fitness Center.

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. The Pivot Fitness Center 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 the Pivot Fitness Center'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, Accesso Partners LLC, Accesso Services LLC, BRI 1855 IDS Center LLC, 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 the Pivot Fitness Center and 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.

PIVOT FITNESS at IDS is managed by AdvantageHealth Corporation.