VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99/week | Automatic weekly direct debit 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.
  • 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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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99 / week | Automatic weekly direct debit 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: VIRTUS Weightlifting — Builder
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

    $44.99 / week | Automatic weekly direct debit via Square

  • Head Coach: Martin Harlowe — one of Australia's best weightlifting coaches, world-renowned & internationally licensed
  • Weekly Investment: $44.99 / week
  • Billing: Automatic weekly direct debit via Square
  • Billing Account: Credit or debit card nominated at payment.

  • Session Times:

    • Friday evenings
    • Saturday mornings
    • Sunday mornings

  • Inclusions:

    • 2x coached Olympic Weightlifting sessions per week
    • Sessions coached by Martin Harlowe — world-renowned, internationally licensed Olympic Weightlifting coach
    • Olympic Weightlifting program delivered and displayed on the gym screen via Lumin Sports
    • Technical feedback and coaching cues each session
    • Access to VIRTUS Centre during all booked sessions

  • SECTION 4 — LIABILITY WAIVER & MEDIA CONSENT

  • Risk Warning

  • VIRTUS Centre warns that whilst you are on the premises, 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
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99 / week | Automatic weekly direct debit via Square
    • 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 you are participating voluntarily and at your own risk.

  • 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.
    • 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. Surveillance is limited to floor areas only and does not extend to bathrooms or private assessment rooms.

  • Media & Marketing Consent

  • From time to time, VIRTUS Centre may capture photos or videos for use in marketing, social media, or promotional materials.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99 / week | Automatic weekly direct debit via Square
  • Note: You may withdraw consent at any time in writing to seb@virtuscentre.com.au.

  • SECTION 5 — PAYMENT TERMS & FAILED PAYMENTS

    • 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 on each billing date.
  • Failed / Dishonoured Payments:
    • A failed payment fee of $5.50 will be applied to your account for any dishonoured payment.
    • VIRTUS Centre will contact you by phone, SMS, or email to notify you of any overdue payment.
    • Repeated failures 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 with a minimum of 30 days written notice.

  • SECTION 6 — COOLING OFF PERIOD

  • All new VIRTUS Centre memberships are subject to a 48-hour cooling off period from the date you enter into this agreement.
    • Cancellation within the cooling off period must be submitted in writing before the 48-hour period expires.
    • A refund of all membership fees minus a $4.99 administration fee will be processed within 7 days.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99 / week | Automatic weekly direct debit via Square
    • After the 48-hour period, the standard cancellation policy applies.

  • SECTION 7 — CANCELLATION POLICY

  • Cancellation by Member:
    • Cancellations must be submitted in writing via email to VIRTUS Centre.
    • A minimum of 14 days written notice is required.
    • Your account must be in good standing — all fees paid and up to date.
    • VIRTUS Centre does not offer refunds on processed weekly payments.
    • Termination for medical reasons must be accompanied by a medical certificate.
  • Termination by VIRTUS Centre:
  • VIRTUS Centre may terminate your membership if you fail to make payments, breach this agreement, engage in improper or unsafe conduct, or are suspected of illegal activity on the premises.

  • SECTION 8 — MEMBERSHIP PAUSE POLICY

  • Members may request to pause their Builder membership under the following conditions:
    • Pause requests must be submitted in writing via email to VIRTUS Centre.
    • Your account must be in good standing with all fees paid at the time of the request.
    • During a pause, a reduced holding fee of $14.99/week will be charged in place of your standard weekly fee.
    • The maximum pause period is 12 months.
    • Your standard weekly fee will resume automatically at the end of your nominated pause period.
  • ▲ Pause periods do not exempt members from the $14.99/week holding fee.
  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.
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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

    $44.99 / week | Automatic weekly direct debit via Square

  • SECTION 9 — GYM ACCESS & SAFETY POLICY

  • Facility Access:
    • Your membership is non-transferable. Only the named member may access VIRTUS Centre using their credentials.
    • No member may bring a non-member into the facility without using the correct procedure.
    • Outside staffed hours, members are responsible for securing the facility as instructed during induction.
    Safe Training:
    • Notify VIRTUS Centre staff of any pain, illness, or injury before using the facility.
    • Use all equipment responsibly and within your current physical capability.
    • Return all equipment to its correct position and wipe down after use.
    Conduct:
    • VIRTUS Centre is an inclusive community. Discrimination, harassment, bullying, or unsafe behaviour will NOT be tolerated and may result in immediate membership termination.
    • Always follow all safety signage and instructions from VIRTUS Centre staff.

  • 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
     - -

  • VIRTUS Centre | This form constitutes a legally binding agreement upon submission.

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  • VIRTUS WEIGHTLIFTING — BUILDER MEMBERSHIP — SIGN-UP & AGREEMENT FORM

  • $44.99 / week | Automatic weekly direct debit via Square
  • 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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