Fairview Fitness Center Membership

Fairview Fitness Center Membership

Join our Fitness Facility at Fairview today! All memberships are for 1 year. Due to insurance requirements, all children between the ages of 13 and 17 must be accompanied by an adult. No children under the age of 13 are allowed.
Please Select:*

New Membership
Today's Enrollment Date*

MonthDayYear
Date
Name*

First NameLast Name
Gender*

MaleFemale
Birthdate*

MonthDayYear
Date
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com
Are you a member of Fairview Baptist Church?*

YesNo
Please list any health conditions/medical issues:

Membership Type*

Individual MembershipIncludes 1 year membership and 1 ID Badge.

$100.00

Family Membership (2+)All members must live in the same household. Includes 2 ID Badges.

$175.00

Additional ID Badge (Family Membership Only) If you have more than 2 members for your family membership, you will need to buy additional ID Badges for each member.

$10.00 Quantity

Enter coupon

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Household Members who will receive a Family Fitness Membership:
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Phone Number
Please enter a valid phone number.
Name

First NameLast Name
Birthdate

MonthDayYear
Date
Phone Number
Please enter a valid phone number.

WAIVER, LIABILITY, AND INDEMNITY AGREEMENT
FITNESS CENTER

In consideration for being permitted to use the facilities of Fairview Baptist Church (“FVBC”), I agree as follows:

1. I agree that if I engage in any physical exercise or activity or use any facility on the premises, I do so at my own risk. This includes, without limitation, my use of the locker room, gymnasium, exercise room, weight room, activity fields, parking area, sidewalk or any equipment in or on the facilities and my participation in any activity, class, program or instruction. I understand that it is recommended that I consult with my physician before beginning any exercise program. I further agree and acknowledge that I have received and have read “Policies and Procedures” for the Fairview Baptist Church ROC and agree to abide by them.

Note: Due to insurance requirements, all children between the ages of 13 and 17 must be accompanied by an adult. No children under the age of 13 are allowed. For the purpose of this facility, the terms “child” or “children” includes all persons under the age of eighteen (18) years old.

2. I agree that I am voluntarily participating in these activities and using these facilities and premises and assume all risk of injury to myself or the contraction of any illness or medical condition that might result, or any damage, loss or theft of any personal property.

3. I agree on behalf of myself (and your personal representatives, heirs, executors, administrators, agents and assigns) to release and discharge FVBC (and its affiliates, employees, agents, representatives, successors and assigns) from any and all claims or causes of action (known or unknown) arising out of FVBC’s negligence. This Waiver and Release of liability includes, without limitation, injuries which may occur as a result of: (a) my use of any exercise equipment or facilities which may malfunction or break; (b) FVBC’s improper maintenance of any exercise equipment or facilities; (c) FVBC’s negligent instruction or supervision; and (d) my slipping and falling while in the facility or on the premises.

4. I agree that in the unfortunate event that I am injured or become ill while participating in any activity at the facility, on FVBC premises, or any off campus trip, that I will hold FVBC and any of its agents harmless. I further authorize FVBC representative(s) and any attending medical personnel, should I be unable to make a decision, to perform medical treatments and/or procedures upon myself as they deem necessary and proper under the circumstances. I agree to indemnify and to hold harmless FVBC, its representatives or attending medical personnel, from any and all actions, related risks and dangers, including negligence damages, and liabilities arising out of the treatment of any sickness or injury. I also agree to assume full financial responsibility for all medical treatment.

5. I give my permission and consent to Fairview Baptist Church for any photographs, videotapes and interviews to be taken during ROC or recreation activities/events to be published and used to illustrate, report, and advertise our ministries including on Internet Web Site promoting or reporting on our church. I acknowledge that I have carefully read this Waiver and Release and fully understand that it is a release of liability. I am waiving any right that I may have to bring a legal action to assert a claim against FVBC.
Head of Household Signature: *Parent or guardian must sign if member is under 18. *

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Family Membership Signatures for all members over 18.
Members Name

First NameLast Name
Signature

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Members Name

First NameLast Name
Signature

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Members Name

First NameLast Name
Signature

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Members Name

First NameLast Name
Signature

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Members Name

First NameLast Name
Signature

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