One Week Free Trial
Free Week Trial is only available to individuals who have not used the facility within the last 3 years.
I'm filling form out for
Myself
Someone Under 18
Email
*
example@example.com
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One Week Free Trial (Under 18)
Must be filled out by a Parent or Guardian at the Health & Fitness Center Front Desk. Participant ID must be presented at the time of sign up.
Parent/Guardian Name
*
First Name
Last Name
Participant Name
*
First Name
Last Name
Parent/Guardian Phone Number
*
Please enter a valid phone number.
Parent/Guardian Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Participant Birth Date (MM/DD/YYYY)
*
-
Month
-
Day
Year
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Select Start Date
*
-
Month
-
Day
Year
Date Picker Icon
By checking this box I'm acknowledgement that because I am filling out this form for someone under 18, sign up will not be complete until we go in person to the Fitness Center, have our paperwork approved, and ID copied by the staff.
*
Yes, I understand
One Week Free Trial
Name
*
First Name
Last Name
Phone Number
*
Please enter a valid phone number.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth (Must be over 18)
*
-
Month
-
Day
Year
Date Picker Icon
Select Start Date
*
-
Month
-
Day
Year
Date Picker Icon
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Additional Information
How did you hear about us?
*
Please Select
Email
Social Media
Website
Program Guide
Referral
Walk In
Other
Fitness Member Name
Who is referring you?
If other, please specify
Current Workout Facility (if applicable)
Emergency Contact Name
*
First Name
Last Name
Emergency Contact Phone Number
*
Please enter a valid phone number.
By checking the box below I understand any damage to the fitness center equipment or other fitness center property during usage will be the financial responsibility of the user.
*
Yes, I understand
As a user of the Fitness Center, I recognize and acknowledge that there are certain risks of physical injury and I agree to assume full risk of any injuries, damages, or losses which I may sustain as a result of participating in the Fitness Center as against the Park District, its officers, agents, servants, and employees. I do hereby fully release and discharge the Park District, its officers, agents, servants, and employees for any and all claims for injuries, damages, or losses I may have or may accrue to me as a result of my participation in the Fitness Center. I further agree to indemnify, hold harmless and defend the Park District and its officers, agents, servants and employees for any and all claims resulting from injuries, damages and losses sustained and arising out of, connected with, or in any way associated with the activities of the Fitness Center. I have read and fully understand this Release and Hold Harmless Agreement.
*
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