PRIME - PREMIUM MEMBERSHIP FORM
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  • PRIME - PREMIUM MEMBERSHIP FORM

  • $74.99/week | Automatic weekly billing via Square
  • Welcome to VIRTUS Centre. Please complete all sections of this form fully and honestly before proceeding to payment. Submitting this form constitutes a legally binding agreement between you and VIRTUS Centre. Please read all policies carefully before signing.

  • SECTION 1 - PERSONAL DETAILS

  • Date of Birth
     - -
  • Gender
  • Format: (000) 000-0000.
  • Format: (000) 000-0000.

  • SECTION 2 - PRE-EXERCISE HEALTH SCREEN

  • Based on the ESSA Adult Pre-Exercise Screening System (APSS) V2, 2019. Please answer all questions honestly. If you answer YES to any question, you may be required to obtain medical clearance before commencing training at VIRTUS Centre. We will contact you directly before your membership is activated.
  • 1. Has a medical practitioner ever told you that you have a heart condition, or have you ever suffered a stroke?
  • 2. Do you ever experience unexplained pain or discomfort in your chest at rest or during physical activity?
  • 3. Do you ever feel faint, dizzy, or lose balance during physical activity?
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM
    $74.99 / week | Automatic weekly billing via Square

  • 4. Have you had an asthma attack requiring immediate medical attention in the last 12 months?
  • 5. If you have diabetes (Type 1 or 2), have you had trouble controlling your blood sugar in the last 3 months?
  • 6. Are you pregnant or have you given birth within the last 12 months?
  • 7. Do you have any diagnosed muscle, bone, tendon, ligament, or joint problems that could be made worse by exercise?
  • 8. Do you have any other condition that may require special consideration for you to exercise?

  • Physical Condition Declaration

  • By proceeding with this form, you represent to VIRTUS Centre that to the best of your knowledge:
    • You do not have any physical, medical, or other condition which may be adversely affected by use of the VIRTUS Centre facility or its equipment.
    • It is your responsibility not to use any equipment that may aggravate a medical condition.
    • If you have any health or medical concerns now or after joining, you must consult your doctor before using the facility.
    • VIRTUS Centre has not provided and cannot provide you with any medical advice.

  • Current Physical Activity Levels

  • Training days/week
  • Typical intensity

  • SECTION 3 — MEMBERSHIP ACKNOWLEDGEMENT

  • Membership Type: Prime Later in Life — Full Membership
    Weekly Investment: $74.99 / week
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM

  • $74.99/week | Automatic weekly billing via Square
  • Billing: Automatic weekly payments via Square
  • Billing Account: Credit or debit card nominated at payment.

  • Available Session Times (Unlimited Access):

    • Monday 6:00pm
    • Tuesday 6:00pm
    • Wednesday 6:00pm
    • Thursday 6:00pm
    • Saturday 8:00am

    *more times will become available in the future*

  • Inclusions:

    • Unlimited access to all Prime Later in Life group sessions
    • 24/7 access to VIRTUS Centre gym facility
    • Group sessions designed to improve overall fitness, strength, mobility, power and psychological wellbeing
    • Purpose-built for people rediscovering themselves later in life
    • Online program delivered via Lumin Sports
    • Periodical challenges built into the program to keep you motivated
    • Access to House of VIRTUS Centre — Skool Community
    • Daily educational content and training resources
    • Direct communication with your coaching team
  • Start Date:
     - -

  • SECTION 4 — LIABILITY WAIVER & MEDIA CONSENT

  • Risk Warning

  • VIRTUS Centre warns that whilst you are on the premises using the facility and its recreational services, you are at risk of suffering physical harm or personal injury including but not limited to:
    • Soft tissue injuries, joint injuries, broken bones, permanent disability, or death
    • Slipping on wet or uneven flooring
    • Being struck by weights or colliding with equipment or other members
    • Engaging in strenuous exercise or activities beyond your current capability
    • Incorrect use of equipment
  • You acknowledge that any such injury may result not only from your own actions but from the actions, omissions, or negligence of others. These risks are not exhaustive — there are other unknown or unanticipated risks that may result in injury, illness, or death. You agree that you are participating voluntarily and at your own risk.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM

  • $74.99/week | Automatic weekly billing via Square

  • Liability Waiver

  • By ticking below, I acknowledge and agree that
    • I am voluntarily participating in activities at VIRTUS Centre.
    • I understand that physical activity and gym use carry inherent risks and I accept full responsibility for any injuries or health issues that may occur.
    • I have disclosed all pre-existing medical conditions or physical limitations in this form and will notify VIRTUS Centre staff of any changes promptly.
    • I release VIRTUS Centre, its owner, coaches, and contractors from any liability for injuries or health complications sustained during or after use of the facility, except where liability cannot be excluded by law.
    • VIRTUS Centre is not responsible for the loss, theft, or damage of personal belongings while on the premises, including but not limited to vehicles, their contents, or items left within the facility.
    • If I cause damage to VIRTUS Centre or any equipment, I am liable for the cost of repair or replacement.

  • Video Surveillance

  • For security purposes, VIRTUS Centre uses video surveillance equipment to monitor the facility. By signing this agreement you acknowledge that by accessing VIRTUS Centre you will be subject to video surveillance and recording. Surveillance is limited to floor areas only and does not extend to bathrooms or private assessment rooms.

  • Media Consent

  • VIRTUS Centre may capture photos and videos during training sessions and general gym use for educational and promotional purposes across platforms including Instagram, TikTok, and YouTube. Content may include group settings and will not indude your name unless agreed separately.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM
    $74.99/week | Automatic weekly billing via Square

  • SECTION 5 — PAYMENT TERMS & FAILED PAYMENTS

  • By signing this agreement, you agree to the following payment terms:
    • All membership fees must be paid before services are delivered.
    • Weekly payments are processed automatically via Square from your nominated billing account.
    • It is your responsibility to ensure sufficient cleared funds are available in your nominated account on each billing date.
    Failed / Dishonoured Payments:
    • In the event that a weekly payment is dishonoured by your financial institution, a failed payment fee of $5.50 will be applied to your account
    • Any additional bank charges or administrative fees incurred as a result of a failed payment are your responsibility.
    • VIRTUS Centre will endeavour to contact you by phone, SMS, or email to notify you of any overdue payment.
    • Repeated failures to meet payment obligations may result in membership suspension or termination by written notice.
    • Any outstanding amounts remain immediately due and payable upon termination.
    Fee Changes:
    • VIRTUS Centre reserves the right to change membership fees at any time. You will be provided with a minimum of 30 days written notice before any fee changes take effect.

  • SECTION 6 — COOLING OFF PERIOD

  • All new VIRTUS Centre memberships are subject to a 48-hour cooling off period beginning from the date you enter into this agreement.
    • A request to cancel within the cooling off period must be submitted in writing to VIRTUS Centre before the 48-hour period expires.
    • If cancelled within the cooling off period, VIRTUS Centre will refund all membership fees minus an administration fee of $4.99.
    • Refunds will be processed within 7 days of receiving your written cancellation request.
    • After the 48-hour cooling off period has expired, the standard cancellation policy applies.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM

  • $74.99/week | Automatic weekly billing via Square

  • SECTION 7 — CANCELLATION POLICY

  • Cancellation by Member:
    • Membership cancellations must be submitted in writing via email to VIRTUS Centre.
    • A minimum of 14 days written notice is required prior to cancellation taking effect.
    • Your membership account must be in good standing — all fees paid and up to date — to be eligible for cancellation.
    • VIRTUS Centre does not offer refunds on processed weekly payments.
    • Any payments processed within the 14-day notice period are non-refundable.
    • Termination for medical reasons (permanent illness or physical incapacity) must be accompanied by a medical certificate. In the event of death, the member's estate must provide a death certificate and any unused fees will be refunded.
  • Termination by VIRTUS Centre:
    • Fail to make any payment of membership fees
    • Breach any part of this agreement, gym rules, or VIRTUS Centre policies
    • Engage in conduct that is improper, unsafe, or harmful to other members or staff
    • Are reasonably suspected of engaging in illegal activity on the premises
    Termination will be effective from the date written notice is issued. You are liable for all financial obligations up to and including the termination date. Upon termination, you will immediately cease to have access to VIRTUS Centre.
  • Group Session Attendance Policy:
    • Group session attendance is not guaranteed and sessions cannot be credited or refunded for non-attendance. Your weekly membership fee remains payable regardless of whether sessions are attended.
    • Missed sessions cannot be credited, refunded, or carried over to another week.
    • Weekly fees apply regardless of attendance.
    • If VIRTUS Centre cancels a session, members will be notified as soon as possible and an alternative session or credit will be offered.

  • SECTION 8 — MEMBERSHIP PAUSE POLICY

  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME — PREMIUM MEMBERSHIP FORM
    $74.99/week | Automatic weekly billing via Square

  • Members may request to pause their Prime Later in Life — Full Membership
    under the following conditions:
    • Pause requests must be submitted in writing via email to VIRTUS Centre.
    • To be eligible for a pause, your account must be in good standing with all fees
      paid and up to date at the time of the request.
    • During a membership pause, a reduced holding fee of $14.99/week will be charged
      to your nominated billing account in place of your standard weekly fee.
    • This holding fee secures your membership spot, gym access, and Skool Community
      access during your pause period.
    • The maximum pause period is 6 months.
    • Your standard weekly membership fee will resume automatically at the end of your
      nominated pause period.
    • If you wish to return before your nominated pause end date, please notify VIRTUS
      Centre in writing and your full membership will be reinstated promptly.
  • ▲ Pause periods do not exempt members from the $14.99/week holding fee.
    Failure to pay the holding fee during a pause may result in membership termination.

  • SECTION 9 — GYM ACCESS & SAFETY POLICY

  • Facility Access:
    • Your membership is non-transferable. Only the member named in this agreement may
      access VIRTUS Centre using their membership credentials.
    • No member is permitted to bring a non-member into the facility or allow another person
      entry without using the correct procedure. Breach of this clause may result in a fee
      and/or membership termination.
    • Outside of staffed hours, members are responsible for securing the facility as instructed
      during induction. This indudes closing and locking all doors and tuming off all lights.
  • Safe Training:
    • Notify VIRTUS Centre staff of any pain, illness, or injury before using the facility.
    • Use all gym equipment responsibly and within your current physical capability.
    • Do not use equipment marked as out of order or restricted during unstaffed hours.
    • Return all equipment to its correct position and wipe down after use.
    • Misuse of equipment may result in a damage fee or restricted access.
  • Conduct:
    • VIRTUS Centre is an inclusive community. Discrimination, harassment, bullying,
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • PRIME - PREMIUM MEMBERSHIP FORM

  • $74.99 / week | Automatic weekly billing via Square
  • intimidation, offensive behaviour, or any conduct that makes others feel unsafe will NOT be tolerated and may result in immediate membership termination.
    • Follow all safety signage and instructions from VIRTUS Centre staff at all times.
    • VIRTUS Centre reserves the right to restrict your membership to staffed hours only if there is concern for your health, safety, or conduct.

  • SECTION 10 - DIGITAL SIGNATURE & DECLARATION

  • By completing this section and submitting this form, you confirm that all information provided is truthful and accurate, and that you have read, understood, and agreed to all VIRTUS Centre policies, waivers, and terms contained in this agreement. Your typed full name below serves as your legally binding digital signature.
  • Today's Date
     - -
  • For any questions about this agreement please contact VIRTUS Centre before submitting. By submitting this form, you confirm all policies are binding from the date of your first payment.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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