Fitness 101 Membership Agreement

Fitness 101 Membership Agreement

Visitor Pass
Name*

First NameLast Name
Email*
example@example.com
Phone Number*
Please enter a valid phone number.
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Preferred Contact Method

PhoneText MessageEmail
Waiver of Liability

By signing below, I agree that the use of Fitness 101 facilities shall be undertaken at my sole risk. I am at least 14 years of age, in good physical health, and suffer no physical impairment which renders use of Fitness 101 facilities unduly dangerous. I hereby waive and release Fitness 101, its officers, employees, and agents from all such liability and related claims, whether or not based on negligence or other fault. I further agree to indemnify Fitness 101 from any injury to my guests.
Signature*

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Date*

MonthDayYear
Date

Membership Type

Day Pass

$15.00 Quantity

Week Pass

$45.00

Month Pass

$70.00

20-Visit Pass20 individual visits. No expiration date.

$240.00

Total

$0.00